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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HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Allen | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Anderson | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Atchison | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 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 | |||||||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Barber | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Barton | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Bourbon | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 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 | |||||||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Brown | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Butler | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Chase | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 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 | |||||||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Chautauqua | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Cherokee | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Cheyenne | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 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 | |||||||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Clark | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Clay | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Cloud | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Coffey | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Comanche | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Cowley | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Crawford | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Decatur | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Dickinson | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Doniphan | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Douglas | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Edwards | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Elk | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Ellis | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Ellsworth | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Finney | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Ford | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Franklin | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Geary | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Gove | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Graham | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Grant | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Gray | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Greeley | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Greenwood | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Hamilton | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Harper | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Harvey | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Haskell | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Hodgeman | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Jackson | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Jefferson | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Jewell | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Johnson | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Kearny | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Kingman | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Kiowa | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Labette | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Lane | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Leavenworth | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Lincoln | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Linn | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Logan | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Lyon | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Marion | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Marshall | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
McPherson | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Meade | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Miami | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Mitchell | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Montgomery | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Morris | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Morton | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Nemaha | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Neosho | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Ness | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Norton | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Osage | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Osborne | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Ottawa | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Pawnee | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Phillips | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Pottawatomie | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Pratt | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Rawlins | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Reno | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Republic | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Rice | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Riley | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Rooks | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Rush | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Russell | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Saline | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Scott | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Sedgwick | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Seward | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Shawnee | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Sheridan | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Sherman | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Smith | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Stafford | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Stanton | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Statewide | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Stevens | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Sumner | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Thomas | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Trego | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Wabaunsee | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Wallace | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Washington | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Wichita | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Wilson | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Woodson | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-013 (Regional PPO) in KS - R5826-013-0 Benefit Details |
Wyandotte | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Adair | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Alfalfa | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Atoka | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Beaver | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Beckham | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Blaine | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Bryan | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Caddo | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Canadian | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Carter | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Cherokee | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Choctaw | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Cimarron | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Cleveland | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Coal | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Comanche | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Cotton | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Craig | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Creek | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Custer | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Delaware | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Dewey | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Ellis | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Garfield | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Garvin | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Grady | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Grant | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Greer | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Harmon | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Harper | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Haskell | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Hughes | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Jackson | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Jefferson | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Johnston | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Kay | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Kingfisher | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Kiowa | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Latimer | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Le Flore | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Lincoln | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Logan | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Love | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Major | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Marshall | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Mayes | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
McClain | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
McCurtain | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
McIntosh | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Murray | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Muskogee | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Noble | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Nowata | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Okfuskee | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Oklahoma | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Okmulgee | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Osage | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Ottawa | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Pawnee | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 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 | |||||||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Payne | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Pittsburg | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Pontotoc | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 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 | |||||||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Pottawatomie | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Pushmataha | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Roger Mills | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 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 | |||||||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Rogers | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Seminole | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Sequoyah | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 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 | |||||||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Statewide | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Stephens | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Texas | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 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 | |||||||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Tillman | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Tulsa | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Wagoner | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 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 | |||||||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Washington | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Washita | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Woods | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 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 | |||||||||
HumanaChoice R5826-013 (Regional PPO) in OK - R5826-013-0 Benefit Details |
Woodward | $163.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
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