2012 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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Today's Options Premier Plus 250A (PFFS) in AZ - H5421-067-0 Benefit Details |
Apache | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in AZ - H5421-067-0 Benefit Details |
Coconino | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in AZ - H5421-067-0 Benefit Details |
Navajo | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 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 | |||||||||
Today's Options Premier Plus 250A (PFFS) in AR - H5421-067-0 Benefit Details |
Van Buren | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in CA - H5421-067-0 Benefit Details |
Butte | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in CA - H5421-067-0 Benefit Details |
Calaveras | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 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 | |||||||||
Today's Options Premier Plus 250A (PFFS) in CA - H5421-067-0 Benefit Details |
Colusa | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in CA - H5421-067-0 Benefit Details |
Humboldt | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in CA - H5421-067-0 Benefit Details |
Imperial | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 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 | |||||||||
Today's Options Premier Plus 250A (PFFS) in CA - H5421-067-0 Benefit Details |
Lake | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in CA - H5421-067-0 Benefit Details |
Mendocino | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in CA - H5421-067-0 Benefit Details |
Merced | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 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 | |||||||||
Today's Options Premier Plus 250A (PFFS) in CA - H5421-067-0 Benefit Details |
Mono | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in CA - H5421-067-0 Benefit Details |
San Benito | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in CA - H5421-067-0 Benefit Details |
Sierra | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 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 | |||||||||
Today's Options Premier Plus 250A (PFFS) in CA - H5421-067-0 Benefit Details |
Siskiyou | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in FL - H5421-067-0 Benefit Details |
Taylor | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in FL - H5421-067-0 Benefit Details |
Washington | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 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 | |||||||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
Banks | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
Barrow | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
Bartow | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 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 | |||||||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
Ben Hill | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
Bibb | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
Burke | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 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 | |||||||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
Butts | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
Candler | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
Carroll | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
Chattooga | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
Colquitt | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
Crawford | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 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 | |||||||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
Crisp | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
Dooly | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
Emanuel | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 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 | |||||||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
Fannin | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
Franklin | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
Gilmer | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
Habersham | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
Hall | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
Hart | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
Houston | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
Jackson | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
Jasper | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
Jenkins | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
Laurens | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
Lincoln | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
Lumpkin | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
McDuffie | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
Murray | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
Peach | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
Pickens | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
Quitman | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 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 | |||||||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
Randolph | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
Spalding | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
Stephens | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 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 | |||||||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
Sumter | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
Tattnall | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
Thomas | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 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 | |||||||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
Tift | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
Towns | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
Treutlen | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 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 | |||||||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
Troup | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
Turner | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
Union | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 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 | |||||||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
Upson | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
Walton | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
Warren | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 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 | |||||||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
Wayne | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
White | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
Whitfield | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 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 | |||||||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
Wilcox | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
Wilkes | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in GA - H5421-067-0 Benefit Details |
Wilkinson | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 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 | |||||||||
Today's Options Premier Plus 250A (PFFS) in ID - H5421-067-0 Benefit Details |
Adams | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in ID - H5421-067-0 Benefit Details |
Bear Lake | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in ID - H5421-067-0 Benefit Details |
Blaine | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 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 | |||||||||
Today's Options Premier Plus 250A (PFFS) in ID - H5421-067-0 Benefit Details |
Lemhi | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in ID - H5421-067-0 Benefit Details |
Lincoln | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in IL - H5421-067-0 Benefit Details |
Clinton | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 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 | |||||||||
Today's Options Premier Plus 250A (PFFS) in IL - H5421-067-0 Benefit Details |
DeKalb | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in IL - H5421-067-0 Benefit Details |
Edwards | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in IL - H5421-067-0 Benefit Details |
Johnson | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in IL - H5421-067-0 Benefit Details |
Macon | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in IL - H5421-067-0 Benefit Details |
Massac | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in IL - H5421-067-0 Benefit Details |
Pope | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 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 | |||||||||
Today's Options Premier Plus 250A (PFFS) in IL - H5421-067-0 Benefit Details |
Richland | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in IL - H5421-067-0 Benefit Details |
Saline | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in IL - H5421-067-0 Benefit Details |
Union | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 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 | |||||||||
Today's Options Premier Plus 250A (PFFS) in IL - H5421-067-0 Benefit Details |
Washington | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in IL - H5421-067-0 Benefit Details |
Williamson | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in IN - H5421-067-0 Benefit Details |
Bartholomew | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 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 | |||||||||
Today's Options Premier Plus 250A (PFFS) in IN - H5421-067-0 Benefit Details |
Cass | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in IN - H5421-067-0 Benefit Details |
Decatur | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in IN - H5421-067-0 Benefit Details |
Dubois | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 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 | |||||||||
Today's Options Premier Plus 250A (PFFS) in IN - H5421-067-0 Benefit Details |
Fayette | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in IN - H5421-067-0 Benefit Details |
Fountain | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in IN - H5421-067-0 Benefit Details |
Grant | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in IN - H5421-067-0 Benefit Details |
Henry | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in IN - H5421-067-0 Benefit Details |
Jasper | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in IN - H5421-067-0 Benefit Details |
Jay | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in IN - H5421-067-0 Benefit Details |
Jefferson | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in IN - H5421-067-0 Benefit Details |
Marshall | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in IN - H5421-067-0 Benefit Details |
Martin | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in IN - H5421-067-0 Benefit Details |
Montgomery | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in IN - H5421-067-0 Benefit Details |
Newton | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in IN - H5421-067-0 Benefit Details |
Ohio | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in IN - H5421-067-0 Benefit Details |
Owen | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in IN - H5421-067-0 Benefit Details |
Parke | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in IN - H5421-067-0 Benefit Details |
Pulaski | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in IN - H5421-067-0 Benefit Details |
Randolph | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in IN - H5421-067-0 Benefit Details |
Ripley | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in IN - H5421-067-0 Benefit Details |
Scott | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in IN - H5421-067-0 Benefit Details |
Steuben | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in IN - H5421-067-0 Benefit Details |
Union | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in IN - H5421-067-0 Benefit Details |
Wayne | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in IA - H5421-067-0 Benefit Details |
Adair | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in IA - H5421-067-0 Benefit Details |
Audubon | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in IA - H5421-067-0 Benefit Details |
Calhoun | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in IA - H5421-067-0 Benefit Details |
Dickinson | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in IA - H5421-067-0 Benefit Details |
Emmet | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in IA - H5421-067-0 Benefit Details |
Humboldt | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in IA - H5421-067-0 Benefit Details |
Ida | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in IA - H5421-067-0 Benefit Details |
Lyon | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in IA - H5421-067-0 Benefit Details |
O'Brien | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in IA - H5421-067-0 Benefit Details |
Sioux | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in IA - H5421-067-0 Benefit Details |
Taylor | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in IA - H5421-067-0 Benefit Details |
Webster | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in KS - H5421-067-0 Benefit Details |
Anderson | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in KS - H5421-067-0 Benefit Details |
Atchison | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in KS - H5421-067-0 Benefit Details |
Clay | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in KS - H5421-067-0 Benefit Details |
Cloud | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in KS - H5421-067-0 Benefit Details |
Coffey | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in KS - H5421-067-0 Benefit Details |
Dickinson | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in KS - H5421-067-0 Benefit Details |
Elk | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in KS - H5421-067-0 Benefit Details |
Ellis | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in KS - H5421-067-0 Benefit Details |
Geary | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in KS - H5421-067-0 Benefit Details |
Gove | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in KS - H5421-067-0 Benefit Details |
Graham | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in KS - H5421-067-0 Benefit Details |
Jefferson | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in KS - H5421-067-0 Benefit Details |
Kiowa | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in KS - H5421-067-0 Benefit Details |
Lane | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in KS - H5421-067-0 Benefit Details |
McPherson | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in KS - H5421-067-0 Benefit Details |
Mitchell | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in KS - H5421-067-0 Benefit Details |
Montgomery | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in KS - H5421-067-0 Benefit Details |
Morris | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 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 | |||||||||
Today's Options Premier Plus 250A (PFFS) in KS - H5421-067-0 Benefit Details |
Nemaha | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in KS - H5421-067-0 Benefit Details |
Neosho | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in KS - H5421-067-0 Benefit Details |
Norton | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in KS - H5421-067-0 Benefit Details |
Osborne | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in KS - H5421-067-0 Benefit Details |
Ottawa | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in KS - H5421-067-0 Benefit Details |
Republic | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in KS - H5421-067-0 Benefit Details |
Riley | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in KS - H5421-067-0 Benefit Details |
Sheridan | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in KS - H5421-067-0 Benefit Details |
Smith | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in KS - H5421-067-0 Benefit Details |
Sumner | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in KS - H5421-067-0 Benefit Details |
Wabaunsee | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in KS - H5421-067-0 Benefit Details |
Washington | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in KY - H5421-067-0 Benefit Details |
Barren | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in KY - H5421-067-0 Benefit Details |
Butler | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in KY - H5421-067-0 Benefit Details |
Christian | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in KY - H5421-067-0 Benefit Details |
Cumberland | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in KY - H5421-067-0 Benefit Details |
Daviess | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in KY - H5421-067-0 Benefit Details |
Edmonson | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in KY - H5421-067-0 Benefit Details |
Elliott | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in KY - H5421-067-0 Benefit Details |
Estill | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in KY - H5421-067-0 Benefit Details |
Gallatin | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in KY - H5421-067-0 Benefit Details |
Garrard | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in KY - H5421-067-0 Benefit Details |
Grant | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in KY - H5421-067-0 Benefit Details |
Harrison | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in KY - H5421-067-0 Benefit Details |
Henderson | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in KY - H5421-067-0 Benefit Details |
Hopkins | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in KY - H5421-067-0 Benefit Details |
Jackson | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 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 | |||||||||
Today's Options Premier Plus 250A (PFFS) in KY - H5421-067-0 Benefit Details |
Larue | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in KY - H5421-067-0 Benefit Details |
Lee | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in KY - H5421-067-0 Benefit Details |
Lincoln | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in KY - H5421-067-0 Benefit Details |
Livingston | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in KY - H5421-067-0 Benefit Details |
Logan | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in KY - H5421-067-0 Benefit Details |
McCreary | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in KY - H5421-067-0 Benefit Details |
McLean | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in KY - H5421-067-0 Benefit Details |
Meade | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in KY - H5421-067-0 Benefit Details |
Mercer | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in KY - H5421-067-0 Benefit Details |
Metcalfe | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in KY - H5421-067-0 Benefit Details |
Morgan | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in KY - H5421-067-0 Benefit Details |
Nelson | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in KY - H5421-067-0 Benefit Details |
Ohio | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in KY - H5421-067-0 Benefit Details |
Robertson | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in KY - H5421-067-0 Benefit Details |
Rockcastle | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in KY - H5421-067-0 Benefit Details |
Rowan | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in KY - H5421-067-0 Benefit Details |
Trigg | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in KY - H5421-067-0 Benefit Details |
Trimble | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in KY - H5421-067-0 Benefit Details |
Washington | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in KY - H5421-067-0 Benefit Details |
Wayne | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in KY - H5421-067-0 Benefit Details |
Webster | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in LA - H5421-067-0 Benefit Details |
Avoyelles | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in LA - H5421-067-0 Benefit Details |
Vernon | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in MI - H5421-067-0 Benefit Details |
Gogebic | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in MI - H5421-067-0 Benefit Details |
Mason | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in MI - H5421-067-0 Benefit Details |
Montmorency | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in MI - H5421-067-0 Benefit Details |
Otsego | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in MS - H5421-067-0 Benefit Details |
Calhoun | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in MS - H5421-067-0 Benefit Details |
Chickasaw | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in MS - H5421-067-0 Benefit Details |
Clay | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in MS - H5421-067-0 Benefit Details |
Franklin | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in MS - H5421-067-0 Benefit Details |
Holmes | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in MS - H5421-067-0 Benefit Details |
Leflore | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in MS - H5421-067-0 Benefit Details |
Monroe | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in MS - H5421-067-0 Benefit Details |
Montgomery | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in MS - H5421-067-0 Benefit Details |
Neshoba | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in MS - H5421-067-0 Benefit Details |
Noxubee | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in MS - H5421-067-0 Benefit Details |
Perry | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in MS - H5421-067-0 Benefit Details |
Pontotoc | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in MO - H5421-067-0 Benefit Details |
Adair | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in MO - H5421-067-0 Benefit Details |
Audrain | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in MO - H5421-067-0 Benefit Details |
Bollinger | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in MO - H5421-067-0 Benefit Details |
Butler | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in MO - H5421-067-0 Benefit Details |
Caldwell | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in MO - H5421-067-0 Benefit Details |
Cape Girardeau | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in MO - H5421-067-0 Benefit Details |
Carter | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in MO - H5421-067-0 Benefit Details |
Clark | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in MO - H5421-067-0 Benefit Details |
Cooper | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in MO - H5421-067-0 Benefit Details |
Harrison | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in MO - H5421-067-0 Benefit Details |
Iron | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in MO - H5421-067-0 Benefit Details |
Knox | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in MO - H5421-067-0 Benefit Details |
Madison | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in MO - H5421-067-0 Benefit Details |
Marion | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in MO - H5421-067-0 Benefit Details |
Monroe | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in MO - H5421-067-0 Benefit Details |
Pemiscot | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in MO - H5421-067-0 Benefit Details |
Pettis | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in MO - H5421-067-0 Benefit Details |
Putnam | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in MO - H5421-067-0 Benefit Details |
Ralls | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in MO - H5421-067-0 Benefit Details |
Scotland | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in MO - H5421-067-0 Benefit Details |
Scott | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in MO - H5421-067-0 Benefit Details |
Shannon | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in MO - H5421-067-0 Benefit Details |
St. Francois | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in MO - H5421-067-0 Benefit Details |
Stoddard | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in MO - H5421-067-0 Benefit Details |
Sullivan | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in MO - H5421-067-0 Benefit Details |
Texas | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in MO - H5421-067-0 Benefit Details |
Vernon | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in MO - H5421-067-0 Benefit Details |
Wayne | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in MT - H5421-067-0 Benefit Details |
Blaine | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in MT - H5421-067-0 Benefit Details |
Chouteau | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in MT - H5421-067-0 Benefit Details |
Daniels | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in MT - H5421-067-0 Benefit Details |
Hill | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in MT - H5421-067-0 Benefit Details |
Meagher | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in MT - H5421-067-0 Benefit Details |
Phillips | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in MT - H5421-067-0 Benefit Details |
Pondera | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in MT - H5421-067-0 Benefit Details |
Roosevelt | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in MT - H5421-067-0 Benefit Details |
Rosebud | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in MT - H5421-067-0 Benefit Details |
Silver Bow | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in MT - H5421-067-0 Benefit Details |
Toole | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in MT - H5421-067-0 Benefit Details |
Treasure | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in MT - H5421-067-0 Benefit Details |
Wheatland | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in NE - H5421-067-0 Benefit Details |
Blaine | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in NE - H5421-067-0 Benefit Details |
Boyd | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in NE - H5421-067-0 Benefit Details |
Brown | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in NE - H5421-067-0 Benefit Details |
Cedar | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 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 | |||||||||
Today's Options Premier Plus 250A (PFFS) in NE - H5421-067-0 Benefit Details |
Dakota | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in NE - H5421-067-0 Benefit Details |
Dawson | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in NE - H5421-067-0 Benefit Details |
Dundy | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 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 | |||||||||
Today's Options Premier Plus 250A (PFFS) in NE - H5421-067-0 Benefit Details |
Furnas | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in NE - H5421-067-0 Benefit Details |
Garfield | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in NE - H5421-067-0 Benefit Details |
Grant | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 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 | |||||||||
Today's Options Premier Plus 250A (PFFS) in NE - H5421-067-0 Benefit Details |
Greeley | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in NE - H5421-067-0 Benefit Details |
Hall | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in NE - H5421-067-0 Benefit Details |
Hamilton | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 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 | |||||||||
Today's Options Premier Plus 250A (PFFS) in NE - H5421-067-0 Benefit Details |
Holt | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in NE - H5421-067-0 Benefit Details |
Keith | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in NE - H5421-067-0 Benefit Details |
Knox | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 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 | |||||||||
Today's Options Premier Plus 250A (PFFS) in NE - H5421-067-0 Benefit Details |
Merrick | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in NE - H5421-067-0 Benefit Details |
Perkins | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in NE - H5421-067-0 Benefit Details |
Phelps | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 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 | |||||||||
Today's Options Premier Plus 250A (PFFS) in NE - H5421-067-0 Benefit Details |
Platte | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in NE - H5421-067-0 Benefit Details |
Rock | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in NE - H5421-067-0 Benefit Details |
Thomas | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 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 | |||||||||
Today's Options Premier Plus 250A (PFFS) in NV - H5421-067-0 Benefit Details |
Lander | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in NC - H5421-067-0 Benefit Details |
Anson | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in NC - H5421-067-0 Benefit Details |
Camden | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 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 | |||||||||
Today's Options Premier Plus 250A (PFFS) in NC - H5421-067-0 Benefit Details |
Cherokee | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in NC - H5421-067-0 Benefit Details |
Cleveland | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in NC - H5421-067-0 Benefit Details |
Jones | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 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 | |||||||||
Today's Options Premier Plus 250A (PFFS) in NC - H5421-067-0 Benefit Details |
Montgomery | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in NC - H5421-067-0 Benefit Details |
Moore | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in NC - H5421-067-0 Benefit Details |
Pamlico | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 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 | |||||||||
Today's Options Premier Plus 250A (PFFS) in NC - H5421-067-0 Benefit Details |
Pasquotank | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in NC - H5421-067-0 Benefit Details |
Rutherford | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in NC - H5421-067-0 Benefit Details |
Scotland | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 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 | |||||||||
Today's Options Premier Plus 250A (PFFS) in NC - H5421-067-0 Benefit Details |
Transylvania | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in ND - H5421-067-0 Benefit Details |
Benson | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in OK - H5421-067-0 Benefit Details |
Beaver | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 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 | |||||||||
Today's Options Premier Plus 250A (PFFS) in OK - H5421-067-0 Benefit Details |
Carter | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in OK - H5421-067-0 Benefit Details |
Comanche | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in OK - H5421-067-0 Benefit Details |
Craig | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in OK - H5421-067-0 Benefit Details |
Dewey | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in OK - H5421-067-0 Benefit Details |
Ellis | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in OK - H5421-067-0 Benefit Details |
Garvin | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 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 | |||||||||
Today's Options Premier Plus 250A (PFFS) in OK - H5421-067-0 Benefit Details |
Jefferson | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in OK - H5421-067-0 Benefit Details |
Kay | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in OK - H5421-067-0 Benefit Details |
Kingfisher | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in OK - H5421-067-0 Benefit Details |
McCurtain | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in OK - H5421-067-0 Benefit Details |
Nowata | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in OK - H5421-067-0 Benefit Details |
Okfuskee | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in OK - H5421-067-0 Benefit Details |
Pontotoc | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in OK - H5421-067-0 Benefit Details |
Pushmataha | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in OK - H5421-067-0 Benefit Details |
Stephens | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 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 | |||||||||
Today's Options Premier Plus 250A (PFFS) in OK - H5421-067-0 Benefit Details |
Texas | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in OK - H5421-067-0 Benefit Details |
Tillman | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in TN - H5421-067-0 Benefit Details |
Cumberland | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 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 | |||||||||
Today's Options Premier Plus 250A (PFFS) in TN - H5421-067-0 Benefit Details |
Lincoln | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in TN - H5421-067-0 Benefit Details |
Perry | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in TN - H5421-067-0 Benefit Details |
Putnam | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 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 | |||||||||
Today's Options Premier Plus 250A (PFFS) in TX - H5421-067-0 Benefit Details |
Brewster | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in TX - H5421-067-0 Benefit Details |
Brown | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in TX - H5421-067-0 Benefit Details |
Calhoun | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in TX - H5421-067-0 Benefit Details |
Callahan | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in TX - H5421-067-0 Benefit Details |
Childress | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in TX - H5421-067-0 Benefit Details |
Clay | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 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 | |||||||||
Today's Options Premier Plus 250A (PFFS) in TX - H5421-067-0 Benefit Details |
Delta | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in TX - H5421-067-0 Benefit Details |
Dickens | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in TX - H5421-067-0 Benefit Details |
Eastland | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 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 | |||||||||
Today's Options Premier Plus 250A (PFFS) in TX - H5421-067-0 Benefit Details |
Gillespie | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in TX - H5421-067-0 Benefit Details |
Hall | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in TX - H5421-067-0 Benefit Details |
Jeff Davis | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in TX - H5421-067-0 Benefit Details |
Jim Hogg | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in TX - H5421-067-0 Benefit Details |
Kent | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in TX - H5421-067-0 Benefit Details |
Lamar | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in TX - H5421-067-0 Benefit Details |
Limestone | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in TX - H5421-067-0 Benefit Details |
McMullen | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in TX - H5421-067-0 Benefit Details |
Montague | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in TX - H5421-067-0 Benefit Details |
Nolan | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in TX - H5421-067-0 Benefit Details |
Ochiltree | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in TX - H5421-067-0 Benefit Details |
Parmer | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in TX - H5421-067-0 Benefit Details |
Reeves | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in TX - H5421-067-0 Benefit Details |
Terrell | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in TX - H5421-067-0 Benefit Details |
Upton | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in TX - H5421-067-0 Benefit Details |
Uvalde | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in TX - H5421-067-0 Benefit Details |
Ward | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in TX - H5421-067-0 Benefit Details |
Webb | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) in TX - H5421-067-0 Benefit Details |
Wheeler | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in TX - H5421-067-0 Benefit Details |
Wilbarger | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in TX - H5421-067-0 Benefit Details |
Winkler | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 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 | |||||||||
Today's Options Premier Plus 250A (PFFS) in TX - H5421-067-0 Benefit Details |
Wise | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in TX - H5421-067-0 Benefit Details |
Yoakum | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in TX - H5421-067-0 Benefit Details |
Zapata | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 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 | |||||||||
Today's Options Premier Plus 250A (PFFS) in VA - H5421-067-0 Benefit Details |
Amherst | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in VA - H5421-067-0 Benefit Details |
Augusta | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in VA - H5421-067-0 Benefit Details |
Covington City | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 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 | |||||||||
Today's Options Premier Plus 250A (PFFS) in VA - H5421-067-0 Benefit Details |
Fauquier | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in VA - H5421-067-0 Benefit Details |
Fredericksburg City | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in VA - H5421-067-0 Benefit Details |
Highland | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 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 | |||||||||
Today's Options Premier Plus 250A (PFFS) in VA - H5421-067-0 Benefit Details |
King George | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in VA - H5421-067-0 Benefit Details |
Patrick | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in VA - H5421-067-0 Benefit Details |
Pulaski | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 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 | |||||||||
Today's Options Premier Plus 250A (PFFS) in VA - H5421-067-0 Benefit Details |
Spotsylvania | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in VA - H5421-067-0 Benefit Details |
Stafford | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in VA - H5421-067-0 Benefit Details |
Waynesboro City | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 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 | |||||||||
Today's Options Premier Plus 250A (PFFS) in WI - H5421-067-0 Benefit Details |
Door | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) in WI - H5421-067-0 Benefit Details |
Florence | $139.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
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