2012 Medicare Advantage Plan Information Click here to jump to the Chart Legend & Search Tips | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
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 |
|||||||||
Today's Options Premier Plus 450E (PFFS) in AZ - H5421-074-0 Benefit Details |
Gila | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in AZ - H5421-074-0 Benefit Details |
La Paz | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in AZ - H5421-074-0 Benefit Details |
Yuma | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in AR - H5421-074-0 Benefit Details |
Chicot | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in AR - H5421-074-0 Benefit Details |
Columbia | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in AR - H5421-074-0 Benefit Details |
Hempstead | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in AR - H5421-074-0 Benefit Details |
Lawrence | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in AR - H5421-074-0 Benefit Details |
Nevada | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in AR - H5421-074-0 Benefit Details |
Sevier | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in CA - H5421-074-0 Benefit Details |
Glenn | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in CA - H5421-074-0 Benefit Details |
Monterey | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in CA - H5421-074-0 Benefit Details |
Plumas | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in CA - H5421-074-0 Benefit Details |
Tehama | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in CA - H5421-074-0 Benefit Details |
Trinity | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in CA - H5421-074-0 Benefit Details |
Tuolumne | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in CO - H5421-074-0 Benefit Details |
Baca | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in FL - H5421-074-0 Benefit Details |
Gilchrist | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in FL - H5421-074-0 Benefit Details |
Gulf | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in FL - H5421-074-0 Benefit Details |
Holmes | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in FL - H5421-074-0 Benefit Details |
Jackson | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in FL - H5421-074-0 Benefit Details |
Lafayette | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in GA - H5421-074-0 Benefit Details |
Appling | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in GA - H5421-074-0 Benefit Details |
Atkinson | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in GA - H5421-074-0 Benefit Details |
Brantley | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in GA - H5421-074-0 Benefit Details |
Brooks | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in GA - H5421-074-0 Benefit Details |
Bulloch | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in GA - H5421-074-0 Benefit Details |
Calhoun | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in GA - H5421-074-0 Benefit Details |
Charlton | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in GA - H5421-074-0 Benefit Details |
Clinch | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in GA - H5421-074-0 Benefit Details |
Echols | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in GA - H5421-074-0 Benefit Details |
Floyd | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in GA - H5421-074-0 Benefit Details |
Glascock | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in GA - H5421-074-0 Benefit Details |
Jefferson | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in GA - H5421-074-0 Benefit Details |
Johnson | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in GA - H5421-074-0 Benefit Details |
Lowndes | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in GA - H5421-074-0 Benefit Details |
Miller | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in GA - H5421-074-0 Benefit Details |
Mitchell | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in GA - H5421-074-0 Benefit Details |
Monroe | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in GA - H5421-074-0 Benefit Details |
Montgomery | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in GA - H5421-074-0 Benefit Details |
Pulaski | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in GA - H5421-074-0 Benefit Details |
Rabun | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in GA - H5421-074-0 Benefit Details |
Seminole | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in GA - H5421-074-0 Benefit Details |
Taylor | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in GA - H5421-074-0 Benefit Details |
Toombs | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in GA - H5421-074-0 Benefit Details |
Worth | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in ID - H5421-074-0 Benefit Details |
Butte | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in ID - H5421-074-0 Benefit Details |
Camas | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in IL - H5421-074-0 Benefit Details |
Alexander | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in IL - H5421-074-0 Benefit Details |
Bond | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in IL - H5421-074-0 Benefit Details |
Franklin | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in IL - H5421-074-0 Benefit Details |
Greene | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in IL - H5421-074-0 Benefit Details |
Hardin | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in IL - H5421-074-0 Benefit Details |
Jackson | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in IL - H5421-074-0 Benefit Details |
Jefferson | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in IL - H5421-074-0 Benefit Details |
Kankakee | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in IL - H5421-074-0 Benefit Details |
Lawrence | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in IL - H5421-074-0 Benefit Details |
Marion | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in IL - H5421-074-0 Benefit Details |
McHenry | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in IL - H5421-074-0 Benefit Details |
Shelby | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in IL - H5421-074-0 Benefit Details |
Wabash | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in IL - H5421-074-0 Benefit Details |
Wayne | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in IL - H5421-074-0 Benefit Details |
White | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in IN - H5421-074-0 Benefit Details |
Benton | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in IN - H5421-074-0 Benefit Details |
Clay | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in IN - H5421-074-0 Benefit Details |
Clinton | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in IN - H5421-074-0 Benefit Details |
Crawford | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in IN - H5421-074-0 Benefit Details |
Daviess | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in IN - H5421-074-0 Benefit Details |
Jennings | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in IN - H5421-074-0 Benefit Details |
La Porte | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in IN - H5421-074-0 Benefit Details |
Miami | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in IN - H5421-074-0 Benefit Details |
Rush | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in IN - H5421-074-0 Benefit Details |
Switzerland | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in IN - H5421-074-0 Benefit Details |
Vermillion | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in IN - H5421-074-0 Benefit Details |
Warren | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in IA - H5421-074-0 Benefit Details |
Adams | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in IA - H5421-074-0 Benefit Details |
Pocahontas | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in IA - H5421-074-0 Benefit Details |
Sac | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in KS - H5421-074-0 Benefit Details |
Allen | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in KS - H5421-074-0 Benefit Details |
Cheyenne | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in KS - H5421-074-0 Benefit Details |
Comanche | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in KS - H5421-074-0 Benefit Details |
Ellsworth | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in KS - H5421-074-0 Benefit Details |
Ford | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in KS - H5421-074-0 Benefit Details |
Gray | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in KS - H5421-074-0 Benefit Details |
Hamilton | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in KS - H5421-074-0 Benefit Details |
Lincoln | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in KS - H5421-074-0 Benefit Details |
Marion | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in KS - H5421-074-0 Benefit Details |
Morton | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in KS - H5421-074-0 Benefit Details |
Osage | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in KS - H5421-074-0 Benefit Details |
Phillips | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in KS - H5421-074-0 Benefit Details |
Pottawatomie | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in KS - H5421-074-0 Benefit Details |
Rawlins | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in KS - H5421-074-0 Benefit Details |
Rooks | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in KS - H5421-074-0 Benefit Details |
Rush | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in KS - H5421-074-0 Benefit Details |
Russell | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in KS - H5421-074-0 Benefit Details |
Seward | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in KS - H5421-074-0 Benefit Details |
Thomas | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in KS - H5421-074-0 Benefit Details |
Wilson | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in KS - H5421-074-0 Benefit Details |
Woodson | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in KY - H5421-074-0 Benefit Details |
Allen | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in KY - H5421-074-0 Benefit Details |
Ballard | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in KY - H5421-074-0 Benefit Details |
Boyd | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in KY - H5421-074-0 Benefit Details |
Boyle | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in KY - H5421-074-0 Benefit Details |
Bracken | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in KY - H5421-074-0 Benefit Details |
Breckinridge | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in KY - H5421-074-0 Benefit Details |
Caldwell | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in KY - H5421-074-0 Benefit Details |
Calloway | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in KY - H5421-074-0 Benefit Details |
Carlisle | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in KY - H5421-074-0 Benefit Details |
Fleming | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in KY - H5421-074-0 Benefit Details |
Grayson | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in KY - H5421-074-0 Benefit Details |
Green | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in KY - H5421-074-0 Benefit Details |
Hancock | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in KY - H5421-074-0 Benefit Details |
Hardin | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in KY - H5421-074-0 Benefit Details |
Harlan | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in KY - H5421-074-0 Benefit Details |
Hart | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in KY - H5421-074-0 Benefit Details |
Hickman | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in KY - H5421-074-0 Benefit Details |
Johnson | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in KY - H5421-074-0 Benefit Details |
Knox | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in KY - H5421-074-0 Benefit Details |
Laurel | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in KY - H5421-074-0 Benefit Details |
Lewis | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in KY - H5421-074-0 Benefit Details |
Lyon | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in KY - H5421-074-0 Benefit Details |
Magoffin | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in KY - H5421-074-0 Benefit Details |
Marshall | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in KY - H5421-074-0 Benefit Details |
Martin | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in KY - H5421-074-0 Benefit Details |
Mason | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in KY - H5421-074-0 Benefit Details |
Monroe | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in KY - H5421-074-0 Benefit Details |
Nicholas | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in KY - H5421-074-0 Benefit Details |
Owsley | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in KY - H5421-074-0 Benefit Details |
Pulaski | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in KY - H5421-074-0 Benefit Details |
Russell | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in KY - H5421-074-0 Benefit Details |
Simpson | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in KY - H5421-074-0 Benefit Details |
Taylor | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in KY - H5421-074-0 Benefit Details |
Union | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in KY - H5421-074-0 Benefit Details |
Whitley | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in LA - H5421-074-0 Benefit Details |
St. Helena | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in MI - H5421-074-0 Benefit Details |
Alcona | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in MI - H5421-074-0 Benefit Details |
Alger | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in MI - H5421-074-0 Benefit Details |
Alpena | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in MI - H5421-074-0 Benefit Details |
Charlevoix | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in MI - H5421-074-0 Benefit Details |
Cheboygan | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in MI - H5421-074-0 Benefit Details |
Chippewa | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in MI - H5421-074-0 Benefit Details |
Delta | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in MI - H5421-074-0 Benefit Details |
Gladwin | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in MI - H5421-074-0 Benefit Details |
Houghton | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in MI - H5421-074-0 Benefit Details |
Iron | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in MI - H5421-074-0 Benefit Details |
Isabella | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in MI - H5421-074-0 Benefit Details |
Lake | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in MI - H5421-074-0 Benefit Details |
Mackinac | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in MI - H5421-074-0 Benefit Details |
Ontonagon | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in MI - H5421-074-0 Benefit Details |
Sanilac | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in MI - H5421-074-0 Benefit Details |
Schoolcraft | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in MS - H5421-074-0 Benefit Details |
Greene | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in MS - H5421-074-0 Benefit Details |
Itawamba | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in MS - H5421-074-0 Benefit Details |
Jasper | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in MS - H5421-074-0 Benefit Details |
Lee | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in MS - H5421-074-0 Benefit Details |
Sharkey | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in MS - H5421-074-0 Benefit Details |
Tallahatchie | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in MS - H5421-074-0 Benefit Details |
Tishomingo | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in MS - H5421-074-0 Benefit Details |
Wayne | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in MS - H5421-074-0 Benefit Details |
Webster | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in MO - H5421-074-0 Benefit Details |
Bates | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in MO - H5421-074-0 Benefit Details |
Camden | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in MO - H5421-074-0 Benefit Details |
Chariton | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in MO - H5421-074-0 Benefit Details |
Dunklin | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in MO - H5421-074-0 Benefit Details |
Grundy | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in MO - H5421-074-0 Benefit Details |
Holt | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in MO - H5421-074-0 Benefit Details |
Howard | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in MO - H5421-074-0 Benefit Details |
Lewis | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in MO - H5421-074-0 Benefit Details |
Macon | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in MO - H5421-074-0 Benefit Details |
Maries | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in MO - H5421-074-0 Benefit Details |
Mercer | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in MO - H5421-074-0 Benefit Details |
Mississippi | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in MO - H5421-074-0 Benefit Details |
Morgan | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in MO - H5421-074-0 Benefit Details |
New Madrid | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in MO - H5421-074-0 Benefit Details |
Pike | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in MO - H5421-074-0 Benefit Details |
Shelby | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in MO - H5421-074-0 Benefit Details |
Worth | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in MT - H5421-074-0 Benefit Details |
Deer Lodge | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in MT - H5421-074-0 Benefit Details |
Liberty | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in MT - H5421-074-0 Benefit Details |
Madison | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in MT - H5421-074-0 Benefit Details |
Teton | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in MT - H5421-074-0 Benefit Details |
Valley | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in NE - H5421-074-0 Benefit Details |
Arthur | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in NE - H5421-074-0 Benefit Details |
Chase | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in NE - H5421-074-0 Benefit Details |
Cherry | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in NE - H5421-074-0 Benefit Details |
Clay | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in NE - H5421-074-0 Benefit Details |
Fillmore | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in NE - H5421-074-0 Benefit Details |
Franklin | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in NE - H5421-074-0 Benefit Details |
Frontier | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in NE - H5421-074-0 Benefit Details |
Garden | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in NE - H5421-074-0 Benefit Details |
Harlan | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in NE - H5421-074-0 Benefit Details |
Hitchcock | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in NE - H5421-074-0 Benefit Details |
Howard | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in NE - H5421-074-0 Benefit Details |
Johnson | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in NE - H5421-074-0 Benefit Details |
Kimball | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in NE - H5421-074-0 Benefit Details |
Nemaha | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in NE - H5421-074-0 Benefit Details |
Pawnee | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in NE - H5421-074-0 Benefit Details |
Pierce | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in NE - H5421-074-0 Benefit Details |
Polk | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in NE - H5421-074-0 Benefit Details |
Red Willow | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in NE - H5421-074-0 Benefit Details |
Saline | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in NE - H5421-074-0 Benefit Details |
Sherman | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in NE - H5421-074-0 Benefit Details |
Thayer | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in NE - H5421-074-0 Benefit Details |
Valley | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in NV - H5421-074-0 Benefit Details |
Elko | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in NV - H5421-074-0 Benefit Details |
Humboldt | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in NV - H5421-074-0 Benefit Details |
Lincoln | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in NV - H5421-074-0 Benefit Details |
Storey | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in NC - H5421-074-0 Benefit Details |
Dare | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in NC - H5421-074-0 Benefit Details |
Swain | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in NC - H5421-074-0 Benefit Details |
Wilson | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in ND - H5421-074-0 Benefit Details |
Bowman | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in ND - H5421-074-0 Benefit Details |
Nelson | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in ND - H5421-074-0 Benefit Details |
Pierce | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in OK - H5421-074-0 Benefit Details |
Cherokee | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in OK - H5421-074-0 Benefit Details |
Custer | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in OK - H5421-074-0 Benefit Details |
Garfield | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in OK - H5421-074-0 Benefit Details |
Grant | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in OK - H5421-074-0 Benefit Details |
Harper | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in OK - H5421-074-0 Benefit Details |
Haskell | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in OK - H5421-074-0 Benefit Details |
Kiowa | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in OK - H5421-074-0 Benefit Details |
Latimer | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in OK - H5421-074-0 Benefit Details |
Love | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in OK - H5421-074-0 Benefit Details |
Major | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in OK - H5421-074-0 Benefit Details |
Murray | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in OK - H5421-074-0 Benefit Details |
Woodward | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in TN - H5421-074-0 Benefit Details |
Fentress | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in TX - H5421-074-0 Benefit Details |
Andrews | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in TX - H5421-074-0 Benefit Details |
Cochran | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in TX - H5421-074-0 Benefit Details |
Comanche | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in TX - H5421-074-0 Benefit Details |
Cottle | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in TX - H5421-074-0 Benefit Details |
Dallam | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in TX - H5421-074-0 Benefit Details |
Dawson | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in TX - H5421-074-0 Benefit Details |
Ector | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in TX - H5421-074-0 Benefit Details |
Erath | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in TX - H5421-074-0 Benefit Details |
Fannin | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in TX - H5421-074-0 Benefit Details |
Foard | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in TX - H5421-074-0 Benefit Details |
Gaines | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in TX - H5421-074-0 Benefit Details |
Goliad | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in TX - H5421-074-0 Benefit Details |
Jackson | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in TX - H5421-074-0 Benefit Details |
Karnes | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in TX - H5421-074-0 Benefit Details |
King | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in TX - H5421-074-0 Benefit Details |
Lavaca | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in TX - H5421-074-0 Benefit Details |
Matagorda | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in TX - H5421-074-0 Benefit Details |
Moore | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in TX - H5421-074-0 Benefit Details |
Motley | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in TX - H5421-074-0 Benefit Details |
Pecos | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in TX - H5421-074-0 Benefit Details |
Real | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in TX - H5421-074-0 Benefit Details |
Refugio | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in TX - H5421-074-0 Benefit Details |
Scurry | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in TX - H5421-074-0 Benefit Details |
Somervell | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in TX - H5421-074-0 Benefit Details |
Stonewall | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in TX - H5421-074-0 Benefit Details |
Swisher | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in TX - H5421-074-0 Benefit Details |
Victoria | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in TX - H5421-074-0 Benefit Details |
Wharton | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in TX - H5421-074-0 Benefit Details |
Young | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 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 450E (PFFS) in VA - H5421-074-0 Benefit Details |
Bath | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in VA - H5421-074-0 Benefit Details |
Westmoreland | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier Plus 450E (PFFS) in WI - H5421-074-0 Benefit Details |
Walworth | $108.00 | $65 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
|