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 - H5421-068-0 Benefit Details |
Gila | $165.00 | $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 - H5421-068-0 Benefit Details |
La Paz | $165.00 | $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 - H5421-068-0 Benefit Details |
Yuma | $165.00 | $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 - H5421-068-0 Benefit Details |
Chicot | $165.00 | $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 AR - H5421-068-0 Benefit Details |
Columbia | $165.00 | $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 AR - H5421-068-0 Benefit Details |
Hempstead | $165.00 | $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 - H5421-068-0 Benefit Details |
Lawrence | $165.00 | $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 AR - H5421-068-0 Benefit Details |
Nevada | $165.00 | $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 AR - H5421-068-0 Benefit Details |
Sevier | $165.00 | $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 - H5421-068-0 Benefit Details |
Glenn | $165.00 | $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 - H5421-068-0 Benefit Details |
Monterey | $165.00 | $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 - H5421-068-0 Benefit Details |
Plumas | $165.00 | $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 - H5421-068-0 Benefit Details |
Tehama | $165.00 | $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 - H5421-068-0 Benefit Details |
Trinity | $165.00 | $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 - H5421-068-0 Benefit Details |
Tuolumne | $165.00 | $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 CO - H5421-068-0 Benefit Details |
Baca | $165.00 | $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 - H5421-068-0 Benefit Details |
Gilchrist | $165.00 | $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 - H5421-068-0 Benefit Details |
Gulf | $165.00 | $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 FL - H5421-068-0 Benefit Details |
Holmes | $165.00 | $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 - H5421-068-0 Benefit Details |
Jackson | $165.00 | $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 - H5421-068-0 Benefit Details |
Lafayette | $165.00 | $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 - H5421-068-0 Benefit Details |
Appling | $165.00 | $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 - H5421-068-0 Benefit Details |
Atkinson | $165.00 | $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 - H5421-068-0 Benefit Details |
Brantley | $165.00 | $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 - H5421-068-0 Benefit Details |
Brooks | $165.00 | $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 - H5421-068-0 Benefit Details |
Bulloch | $165.00 | $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 - H5421-068-0 Benefit Details |
Calhoun | $165.00 | $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 - H5421-068-0 Benefit Details |
Charlton | $165.00 | $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 - H5421-068-0 Benefit Details |
Clinch | $165.00 | $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 - H5421-068-0 Benefit Details |
Echols | $165.00 | $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 - H5421-068-0 Benefit Details |
Floyd | $165.00 | $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 - H5421-068-0 Benefit Details |
Glascock | $165.00 | $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 - H5421-068-0 Benefit Details |
Jefferson | $165.00 | $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 - H5421-068-0 Benefit Details |
Johnson | $165.00 | $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 - H5421-068-0 Benefit Details |
Lowndes | $165.00 | $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 - H5421-068-0 Benefit Details |
Miller | $165.00 | $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 - H5421-068-0 Benefit Details |
Mitchell | $165.00 | $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 - H5421-068-0 Benefit Details |
Monroe | $165.00 | $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 - H5421-068-0 Benefit Details |
Montgomery | $165.00 | $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 - H5421-068-0 Benefit Details |
Pulaski | $165.00 | $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 - H5421-068-0 Benefit Details |
Rabun | $165.00 | $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 - H5421-068-0 Benefit Details |
Seminole | $165.00 | $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 - H5421-068-0 Benefit Details |
Taylor | $165.00 | $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 - H5421-068-0 Benefit Details |
Toombs | $165.00 | $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 - H5421-068-0 Benefit Details |
Worth | $165.00 | $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 ID - H5421-068-0 Benefit Details |
Butte | $165.00 | $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 - H5421-068-0 Benefit Details |
Camas | $165.00 | $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 - H5421-068-0 Benefit Details |
Alexander | $165.00 | $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 - H5421-068-0 Benefit Details |
Bond | $165.00 | $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 - H5421-068-0 Benefit Details |
Franklin | $165.00 | $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 - H5421-068-0 Benefit Details |
Greene | $165.00 | $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 - H5421-068-0 Benefit Details |
Hardin | $165.00 | $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 - H5421-068-0 Benefit Details |
Jackson | $165.00 | $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 - H5421-068-0 Benefit Details |
Jefferson | $165.00 | $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 - H5421-068-0 Benefit Details |
Kankakee | $165.00 | $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 - H5421-068-0 Benefit Details |
Lawrence | $165.00 | $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 - H5421-068-0 Benefit Details |
Marion | $165.00 | $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 - H5421-068-0 Benefit Details |
McHenry | $165.00 | $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 - H5421-068-0 Benefit Details |
Shelby | $165.00 | $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 - H5421-068-0 Benefit Details |
Wabash | $165.00 | $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 - H5421-068-0 Benefit Details |
Wayne | $165.00 | $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 - H5421-068-0 Benefit Details |
White | $165.00 | $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 - H5421-068-0 Benefit Details |
Benton | $165.00 | $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 - H5421-068-0 Benefit Details |
Clay | $165.00 | $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 - H5421-068-0 Benefit Details |
Clinton | $165.00 | $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 - H5421-068-0 Benefit Details |
Crawford | $165.00 | $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 - H5421-068-0 Benefit Details |
Daviess | $165.00 | $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 - H5421-068-0 Benefit Details |
Jennings | $165.00 | $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 - H5421-068-0 Benefit Details |
La Porte | $165.00 | $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 - H5421-068-0 Benefit Details |
Miami | $165.00 | $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 - H5421-068-0 Benefit Details |
Rush | $165.00 | $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 - H5421-068-0 Benefit Details |
Switzerland | $165.00 | $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 - H5421-068-0 Benefit Details |
Vermillion | $165.00 | $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 - H5421-068-0 Benefit Details |
Warren | $165.00 | $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 - H5421-068-0 Benefit Details |
Adams | $165.00 | $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 IA - H5421-068-0 Benefit Details |
Pocahontas | $165.00 | $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 - H5421-068-0 Benefit Details |
Sac | $165.00 | $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 - H5421-068-0 Benefit Details |
Allen | $165.00 | $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 - H5421-068-0 Benefit Details |
Cheyenne | $165.00 | $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 - H5421-068-0 Benefit Details |
Comanche | $165.00 | $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 - H5421-068-0 Benefit Details |
Ellsworth | $165.00 | $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 - H5421-068-0 Benefit Details |
Ford | $165.00 | $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 - H5421-068-0 Benefit Details |
Gray | $165.00 | $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 - H5421-068-0 Benefit Details |
Hamilton | $165.00 | $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 - H5421-068-0 Benefit Details |
Lincoln | $165.00 | $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 - H5421-068-0 Benefit Details |
Marion | $165.00 | $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 - H5421-068-0 Benefit Details |
Morton | $165.00 | $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 - H5421-068-0 Benefit Details |
Osage | $165.00 | $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 - H5421-068-0 Benefit Details |
Phillips | $165.00 | $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 - H5421-068-0 Benefit Details |
Pottawatomie | $165.00 | $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 - H5421-068-0 Benefit Details |
Rawlins | $165.00 | $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 - H5421-068-0 Benefit Details |
Rooks | $165.00 | $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 - H5421-068-0 Benefit Details |
Rush | $165.00 | $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 - H5421-068-0 Benefit Details |
Russell | $165.00 | $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 - H5421-068-0 Benefit Details |
Seward | $165.00 | $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 - H5421-068-0 Benefit Details |
Thomas | $165.00 | $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 - H5421-068-0 Benefit Details |
Wilson | $165.00 | $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 - H5421-068-0 Benefit Details |
Woodson | $165.00 | $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 - H5421-068-0 Benefit Details |
Allen | $165.00 | $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 - H5421-068-0 Benefit Details |
Ballard | $165.00 | $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 - H5421-068-0 Benefit Details |
Boyd | $165.00 | $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 - H5421-068-0 Benefit Details |
Boyle | $165.00 | $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 - H5421-068-0 Benefit Details |
Bracken | $165.00 | $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 - H5421-068-0 Benefit Details |
Breckinridge | $165.00 | $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 - H5421-068-0 Benefit Details |
Caldwell | $165.00 | $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 - H5421-068-0 Benefit Details |
Calloway | $165.00 | $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 - H5421-068-0 Benefit Details |
Carlisle | $165.00 | $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 - H5421-068-0 Benefit Details |
Fleming | $165.00 | $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 - H5421-068-0 Benefit Details |
Grayson | $165.00 | $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 - H5421-068-0 Benefit Details |
Green | $165.00 | $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 - H5421-068-0 Benefit Details |
Hancock | $165.00 | $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 - H5421-068-0 Benefit Details |
Hardin | $165.00 | $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 - H5421-068-0 Benefit Details |
Harlan | $165.00 | $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 - H5421-068-0 Benefit Details |
Hart | $165.00 | $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 - H5421-068-0 Benefit Details |
Hickman | $165.00 | $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 - H5421-068-0 Benefit Details |
Johnson | $165.00 | $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 - H5421-068-0 Benefit Details |
Knox | $165.00 | $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 - H5421-068-0 Benefit Details |
Laurel | $165.00 | $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 - H5421-068-0 Benefit Details |
Lewis | $165.00 | $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 - H5421-068-0 Benefit Details |
Lyon | $165.00 | $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 - H5421-068-0 Benefit Details |
Magoffin | $165.00 | $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 - H5421-068-0 Benefit Details |
Marshall | $165.00 | $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 - H5421-068-0 Benefit Details |
Martin | $165.00 | $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 - H5421-068-0 Benefit Details |
Mason | $165.00 | $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 - H5421-068-0 Benefit Details |
Monroe | $165.00 | $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 - H5421-068-0 Benefit Details |
Nicholas | $165.00 | $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 - H5421-068-0 Benefit Details |
Owsley | $165.00 | $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 - H5421-068-0 Benefit Details |
Pulaski | $165.00 | $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 - H5421-068-0 Benefit Details |
Russell | $165.00 | $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 - H5421-068-0 Benefit Details |
Simpson | $165.00 | $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 - H5421-068-0 Benefit Details |
Taylor | $165.00 | $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 - H5421-068-0 Benefit Details |
Union | $165.00 | $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 - H5421-068-0 Benefit Details |
Whitley | $165.00 | $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 - H5421-068-0 Benefit Details |
St. Helena | $165.00 | $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 - H5421-068-0 Benefit Details |
Alcona | $165.00 | $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 - H5421-068-0 Benefit Details |
Alger | $165.00 | $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 - H5421-068-0 Benefit Details |
Alpena | $165.00 | $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 - H5421-068-0 Benefit Details |
Charlevoix | $165.00 | $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 - H5421-068-0 Benefit Details |
Cheboygan | $165.00 | $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 - H5421-068-0 Benefit Details |
Chippewa | $165.00 | $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 - H5421-068-0 Benefit Details |
Delta | $165.00 | $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 - H5421-068-0 Benefit Details |
Gladwin | $165.00 | $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 - H5421-068-0 Benefit Details |
Houghton | $165.00 | $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 - H5421-068-0 Benefit Details |
Iron | $165.00 | $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 - H5421-068-0 Benefit Details |
Isabella | $165.00 | $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 - H5421-068-0 Benefit Details |
Lake | $165.00 | $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 - H5421-068-0 Benefit Details |
Mackinac | $165.00 | $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 - H5421-068-0 Benefit Details |
Ontonagon | $165.00 | $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 - H5421-068-0 Benefit Details |
Sanilac | $165.00 | $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 - H5421-068-0 Benefit Details |
Schoolcraft | $165.00 | $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 - H5421-068-0 Benefit Details |
Greene | $165.00 | $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 - H5421-068-0 Benefit Details |
Itawamba | $165.00 | $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 - H5421-068-0 Benefit Details |
Jasper | $165.00 | $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 - H5421-068-0 Benefit Details |
Lee | $165.00 | $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 - H5421-068-0 Benefit Details |
Sharkey | $165.00 | $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 - H5421-068-0 Benefit Details |
Tallahatchie | $165.00 | $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 - H5421-068-0 Benefit Details |
Tishomingo | $165.00 | $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 - H5421-068-0 Benefit Details |
Wayne | $165.00 | $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 - H5421-068-0 Benefit Details |
Webster | $165.00 | $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 - H5421-068-0 Benefit Details |
Bates | $165.00 | $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 - H5421-068-0 Benefit Details |
Camden | $165.00 | $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 - H5421-068-0 Benefit Details |
Chariton | $165.00 | $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 - H5421-068-0 Benefit Details |
Dunklin | $165.00 | $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 - H5421-068-0 Benefit Details |
Grundy | $165.00 | $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 - H5421-068-0 Benefit Details |
Holt | $165.00 | $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 - H5421-068-0 Benefit Details |
Howard | $165.00 | $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 - H5421-068-0 Benefit Details |
Lewis | $165.00 | $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 - H5421-068-0 Benefit Details |
Macon | $165.00 | $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 - H5421-068-0 Benefit Details |
Maries | $165.00 | $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 - H5421-068-0 Benefit Details |
Mercer | $165.00 | $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 - H5421-068-0 Benefit Details |
Mississippi | $165.00 | $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 MO - H5421-068-0 Benefit Details |
Morgan | $165.00 | $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 - H5421-068-0 Benefit Details |
New Madrid | $165.00 | $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 - H5421-068-0 Benefit Details |
Pike | $165.00 | $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 - H5421-068-0 Benefit Details |
Shelby | $165.00 | $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 - H5421-068-0 Benefit Details |
Worth | $165.00 | $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 - H5421-068-0 Benefit Details |
Deer Lodge | $165.00 | $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 - H5421-068-0 Benefit Details |
Liberty | $165.00 | $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 - H5421-068-0 Benefit Details |
Madison | $165.00 | $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 - H5421-068-0 Benefit Details |
Teton | $165.00 | $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 - H5421-068-0 Benefit Details |
Valley | $165.00 | $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 - H5421-068-0 Benefit Details |
Arthur | $165.00 | $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 - H5421-068-0 Benefit Details |
Chase | $165.00 | $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 - H5421-068-0 Benefit Details |
Cherry | $165.00 | $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 - H5421-068-0 Benefit Details |
Clay | $165.00 | $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 - H5421-068-0 Benefit Details |
Fillmore | $165.00 | $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 - H5421-068-0 Benefit Details |
Franklin | $165.00 | $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 - H5421-068-0 Benefit Details |
Frontier | $165.00 | $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 - H5421-068-0 Benefit Details |
Garden | $165.00 | $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 - H5421-068-0 Benefit Details |
Harlan | $165.00 | $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 - H5421-068-0 Benefit Details |
Hitchcock | $165.00 | $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 - H5421-068-0 Benefit Details |
Howard | $165.00 | $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 - H5421-068-0 Benefit Details |
Johnson | $165.00 | $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 - H5421-068-0 Benefit Details |
Kimball | $165.00 | $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 - H5421-068-0 Benefit Details |
Nemaha | $165.00 | $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 - H5421-068-0 Benefit Details |
Pawnee | $165.00 | $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 - H5421-068-0 Benefit Details |
Pierce | $165.00 | $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 - H5421-068-0 Benefit Details |
Polk | $165.00 | $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 - H5421-068-0 Benefit Details |
Red Willow | $165.00 | $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 - H5421-068-0 Benefit Details |
Saline | $165.00 | $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 - H5421-068-0 Benefit Details |
Sherman | $165.00 | $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 - H5421-068-0 Benefit Details |
Thayer | $165.00 | $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 - H5421-068-0 Benefit Details |
Valley | $165.00 | $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 NV - H5421-068-0 Benefit Details |
Elko | $165.00 | $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 NV - H5421-068-0 Benefit Details |
Humboldt | $165.00 | $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 NV - H5421-068-0 Benefit Details |
Lincoln | $165.00 | $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 NV - H5421-068-0 Benefit Details |
Storey | $165.00 | $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 NC - H5421-068-0 Benefit Details |
Dare | $165.00 | $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 - H5421-068-0 Benefit Details |
Swain | $165.00 | $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 - H5421-068-0 Benefit Details |
Wilson | $165.00 | $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 ND - H5421-068-0 Benefit Details |
Bowman | $165.00 | $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 - H5421-068-0 Benefit Details |
Nelson | $165.00 | $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 - H5421-068-0 Benefit Details |
Pierce | $165.00 | $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 - H5421-068-0 Benefit Details |
Cherokee | $165.00 | $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 - H5421-068-0 Benefit Details |
Custer | $165.00 | $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 - H5421-068-0 Benefit Details |
Garfield | $165.00 | $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 - H5421-068-0 Benefit Details |
Grant | $165.00 | $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 - H5421-068-0 Benefit Details |
Harper | $165.00 | $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 - H5421-068-0 Benefit Details |
Haskell | $165.00 | $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 - H5421-068-0 Benefit Details |
Kiowa | $165.00 | $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 - H5421-068-0 Benefit Details |
Latimer | $165.00 | $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 - H5421-068-0 Benefit Details |
Love | $165.00 | $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 - H5421-068-0 Benefit Details |
Major | $165.00 | $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 - H5421-068-0 Benefit Details |
Murray | $165.00 | $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 - H5421-068-0 Benefit Details |
Woodward | $165.00 | $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 TN - H5421-068-0 Benefit Details |
Fentress | $165.00 | $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 - H5421-068-0 Benefit Details |
Andrews | $165.00 | $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 - H5421-068-0 Benefit Details |
Cochran | $165.00 | $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 - H5421-068-0 Benefit Details |
Comanche | $165.00 | $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 - H5421-068-0 Benefit Details |
Cottle | $165.00 | $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 - H5421-068-0 Benefit Details |
Dallam | $165.00 | $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 - H5421-068-0 Benefit Details |
Dawson | $165.00 | $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 - H5421-068-0 Benefit Details |
Ector | $165.00 | $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 - H5421-068-0 Benefit Details |
Erath | $165.00 | $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 - H5421-068-0 Benefit Details |
Fannin | $165.00 | $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 - H5421-068-0 Benefit Details |
Foard | $165.00 | $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 - H5421-068-0 Benefit Details |
Gaines | $165.00 | $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 - H5421-068-0 Benefit Details |
Goliad | $165.00 | $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 - H5421-068-0 Benefit Details |
Jackson | $165.00 | $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 - H5421-068-0 Benefit Details |
Karnes | $165.00 | $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 - H5421-068-0 Benefit Details |
King | $165.00 | $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 - H5421-068-0 Benefit Details |
Lavaca | $165.00 | $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 - H5421-068-0 Benefit Details |
Matagorda | $165.00 | $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 - H5421-068-0 Benefit Details |
Moore | $165.00 | $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 - H5421-068-0 Benefit Details |
Motley | $165.00 | $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 - H5421-068-0 Benefit Details |
Pecos | $165.00 | $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 - H5421-068-0 Benefit Details |
Real | $165.00 | $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 - H5421-068-0 Benefit Details |
Refugio | $165.00 | $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 - H5421-068-0 Benefit Details |
Scurry | $165.00 | $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 - H5421-068-0 Benefit Details |
Somervell | $165.00 | $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 - H5421-068-0 Benefit Details |
Stonewall | $165.00 | $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 - H5421-068-0 Benefit Details |
Swisher | $165.00 | $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 - H5421-068-0 Benefit Details |
Victoria | $165.00 | $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 - H5421-068-0 Benefit Details |
Wharton | $165.00 | $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 - H5421-068-0 Benefit Details |
Young | $165.00 | $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 - H5421-068-0 Benefit Details |
Bath | $165.00 | $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 - H5421-068-0 Benefit Details |
Westmoreland | $165.00 | $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 - H5421-068-0 Benefit Details |
Walworth | $165.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
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