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 200 (PFFS) in AZ - H5421-210-0 Benefit Details |
Gila | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in AZ - H5421-210-0 Benefit Details |
La Paz | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in AZ - H5421-210-0 Benefit Details |
Yuma | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in AR - H5421-210-0 Benefit Details |
Chicot | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in AR - H5421-210-0 Benefit Details |
Columbia | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in AR - H5421-210-0 Benefit Details |
Hempstead | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in AR - H5421-210-0 Benefit Details |
Lawrence | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in AR - H5421-210-0 Benefit Details |
Nevada | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in AR - H5421-210-0 Benefit Details |
Sevier | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in CA - H5421-210-0 Benefit Details |
Glenn | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in CA - H5421-210-0 Benefit Details |
Monterey | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in CA - H5421-210-0 Benefit Details |
Plumas | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in CA - H5421-210-0 Benefit Details |
Tehama | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in CA - H5421-210-0 Benefit Details |
Trinity | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in CA - H5421-210-0 Benefit Details |
Tuolumne | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in CO - H5421-210-0 Benefit Details |
Baca | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in FL - H5421-210-0 Benefit Details |
Gilchrist | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in FL - H5421-210-0 Benefit Details |
Gulf | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in FL - H5421-210-0 Benefit Details |
Holmes | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in FL - H5421-210-0 Benefit Details |
Jackson | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in FL - H5421-210-0 Benefit Details |
Lafayette | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in GA - H5421-210-0 Benefit Details |
Appling | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in GA - H5421-210-0 Benefit Details |
Atkinson | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in GA - H5421-210-0 Benefit Details |
Brantley | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in GA - H5421-210-0 Benefit Details |
Brooks | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in GA - H5421-210-0 Benefit Details |
Bulloch | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in GA - H5421-210-0 Benefit Details |
Calhoun | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in GA - H5421-210-0 Benefit Details |
Charlton | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in GA - H5421-210-0 Benefit Details |
Clinch | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in GA - H5421-210-0 Benefit Details |
Echols | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in GA - H5421-210-0 Benefit Details |
Floyd | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in GA - H5421-210-0 Benefit Details |
Glascock | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in GA - H5421-210-0 Benefit Details |
Jefferson | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in GA - H5421-210-0 Benefit Details |
Johnson | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in GA - H5421-210-0 Benefit Details |
Lowndes | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in GA - H5421-210-0 Benefit Details |
Miller | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in GA - H5421-210-0 Benefit Details |
Mitchell | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in GA - H5421-210-0 Benefit Details |
Monroe | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in GA - H5421-210-0 Benefit Details |
Montgomery | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in GA - H5421-210-0 Benefit Details |
Pulaski | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in GA - H5421-210-0 Benefit Details |
Rabun | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in GA - H5421-210-0 Benefit Details |
Seminole | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in GA - H5421-210-0 Benefit Details |
Taylor | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in GA - H5421-210-0 Benefit Details |
Toombs | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in GA - H5421-210-0 Benefit Details |
Worth | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in ID - H5421-210-0 Benefit Details |
Butte | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in ID - H5421-210-0 Benefit Details |
Camas | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in IL - H5421-210-0 Benefit Details |
Alexander | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in IL - H5421-210-0 Benefit Details |
Bond | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in IL - H5421-210-0 Benefit Details |
Franklin | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in IL - H5421-210-0 Benefit Details |
Greene | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in IL - H5421-210-0 Benefit Details |
Hardin | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in IL - H5421-210-0 Benefit Details |
Jackson | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in IL - H5421-210-0 Benefit Details |
Jefferson | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in IL - H5421-210-0 Benefit Details |
Kankakee | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in IL - H5421-210-0 Benefit Details |
Lawrence | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in IL - H5421-210-0 Benefit Details |
Marion | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in IL - H5421-210-0 Benefit Details |
McHenry | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in IL - H5421-210-0 Benefit Details |
Shelby | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in IL - H5421-210-0 Benefit Details |
Wabash | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in IL - H5421-210-0 Benefit Details |
Wayne | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in IL - H5421-210-0 Benefit Details |
White | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in IN - H5421-210-0 Benefit Details |
Benton | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in IN - H5421-210-0 Benefit Details |
Clay | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in IN - H5421-210-0 Benefit Details |
Clinton | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in IN - H5421-210-0 Benefit Details |
Crawford | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in IN - H5421-210-0 Benefit Details |
Daviess | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in IN - H5421-210-0 Benefit Details |
Jennings | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in IN - H5421-210-0 Benefit Details |
La Porte | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in IN - H5421-210-0 Benefit Details |
Miami | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in IN - H5421-210-0 Benefit Details |
Rush | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in IN - H5421-210-0 Benefit Details |
Switzerland | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in IN - H5421-210-0 Benefit Details |
Vermillion | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in IN - H5421-210-0 Benefit Details |
Warren | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in IA - H5421-210-0 Benefit Details |
Adams | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in IA - H5421-210-0 Benefit Details |
Pocahontas | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in IA - H5421-210-0 Benefit Details |
Sac | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in KS - H5421-210-0 Benefit Details |
Allen | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in KS - H5421-210-0 Benefit Details |
Cheyenne | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in KS - H5421-210-0 Benefit Details |
Comanche | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in KS - H5421-210-0 Benefit Details |
Ellsworth | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in KS - H5421-210-0 Benefit Details |
Ford | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in KS - H5421-210-0 Benefit Details |
Gray | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in KS - H5421-210-0 Benefit Details |
Hamilton | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in KS - H5421-210-0 Benefit Details |
Lincoln | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in KS - H5421-210-0 Benefit Details |
Marion | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in KS - H5421-210-0 Benefit Details |
Morton | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in KS - H5421-210-0 Benefit Details |
Osage | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in KS - H5421-210-0 Benefit Details |
Phillips | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in KS - H5421-210-0 Benefit Details |
Pottawatomie | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in KS - H5421-210-0 Benefit Details |
Rawlins | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in KS - H5421-210-0 Benefit Details |
Rooks | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in KS - H5421-210-0 Benefit Details |
Rush | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in KS - H5421-210-0 Benefit Details |
Russell | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in KS - H5421-210-0 Benefit Details |
Seward | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in KS - H5421-210-0 Benefit Details |
Thomas | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in KS - H5421-210-0 Benefit Details |
Wilson | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in KS - H5421-210-0 Benefit Details |
Woodson | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in KY - H5421-210-0 Benefit Details |
Allen | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in KY - H5421-210-0 Benefit Details |
Ballard | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in KY - H5421-210-0 Benefit Details |
Boyd | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in KY - H5421-210-0 Benefit Details |
Boyle | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in KY - H5421-210-0 Benefit Details |
Bracken | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in KY - H5421-210-0 Benefit Details |
Breckinridge | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in KY - H5421-210-0 Benefit Details |
Caldwell | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in KY - H5421-210-0 Benefit Details |
Calloway | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in KY - H5421-210-0 Benefit Details |
Carlisle | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in KY - H5421-210-0 Benefit Details |
Fleming | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in KY - H5421-210-0 Benefit Details |
Grayson | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in KY - H5421-210-0 Benefit Details |
Green | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in KY - H5421-210-0 Benefit Details |
Hancock | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in KY - H5421-210-0 Benefit Details |
Hardin | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in KY - H5421-210-0 Benefit Details |
Harlan | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in KY - H5421-210-0 Benefit Details |
Hart | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in KY - H5421-210-0 Benefit Details |
Hickman | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in KY - H5421-210-0 Benefit Details |
Johnson | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in KY - H5421-210-0 Benefit Details |
Knox | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in KY - H5421-210-0 Benefit Details |
Laurel | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in KY - H5421-210-0 Benefit Details |
Lewis | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in KY - H5421-210-0 Benefit Details |
Lyon | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in KY - H5421-210-0 Benefit Details |
Magoffin | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in KY - H5421-210-0 Benefit Details |
Marshall | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in KY - H5421-210-0 Benefit Details |
Martin | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in KY - H5421-210-0 Benefit Details |
Mason | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in KY - H5421-210-0 Benefit Details |
Monroe | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in KY - H5421-210-0 Benefit Details |
Nicholas | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in KY - H5421-210-0 Benefit Details |
Owsley | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in KY - H5421-210-0 Benefit Details |
Pulaski | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in KY - H5421-210-0 Benefit Details |
Russell | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in KY - H5421-210-0 Benefit Details |
Simpson | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in KY - H5421-210-0 Benefit Details |
Taylor | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in KY - H5421-210-0 Benefit Details |
Union | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in KY - H5421-210-0 Benefit Details |
Whitley | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in LA - H5421-210-0 Benefit Details |
St. Helena | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in MI - H5421-210-0 Benefit Details |
Alcona | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in MI - H5421-210-0 Benefit Details |
Alger | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in MI - H5421-210-0 Benefit Details |
Alpena | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in MI - H5421-210-0 Benefit Details |
Charlevoix | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in MI - H5421-210-0 Benefit Details |
Cheboygan | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in MI - H5421-210-0 Benefit Details |
Chippewa | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in MI - H5421-210-0 Benefit Details |
Delta | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in MI - H5421-210-0 Benefit Details |
Gladwin | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in MI - H5421-210-0 Benefit Details |
Houghton | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in MI - H5421-210-0 Benefit Details |
Iron | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in MI - H5421-210-0 Benefit Details |
Isabella | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in MI - H5421-210-0 Benefit Details |
Lake | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in MI - H5421-210-0 Benefit Details |
Mackinac | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in MI - H5421-210-0 Benefit Details |
Ontonagon | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in MI - H5421-210-0 Benefit Details |
Sanilac | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in MI - H5421-210-0 Benefit Details |
Schoolcraft | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in MS - H5421-210-0 Benefit Details |
Greene | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in MS - H5421-210-0 Benefit Details |
Itawamba | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in MS - H5421-210-0 Benefit Details |
Jasper | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in MS - H5421-210-0 Benefit Details |
Lee | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in MS - H5421-210-0 Benefit Details |
Sharkey | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in MS - H5421-210-0 Benefit Details |
Tallahatchie | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in MS - H5421-210-0 Benefit Details |
Tishomingo | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in MS - H5421-210-0 Benefit Details |
Wayne | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in MS - H5421-210-0 Benefit Details |
Webster | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in MO - H5421-210-0 Benefit Details |
Bates | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in MO - H5421-210-0 Benefit Details |
Camden | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in MO - H5421-210-0 Benefit Details |
Chariton | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in MO - H5421-210-0 Benefit Details |
Dunklin | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in MO - H5421-210-0 Benefit Details |
Grundy | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in MO - H5421-210-0 Benefit Details |
Holt | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in MO - H5421-210-0 Benefit Details |
Howard | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in MO - H5421-210-0 Benefit Details |
Lewis | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in MO - H5421-210-0 Benefit Details |
Macon | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in MO - H5421-210-0 Benefit Details |
Maries | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in MO - H5421-210-0 Benefit Details |
Mercer | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in MO - H5421-210-0 Benefit Details |
Mississippi | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in MO - H5421-210-0 Benefit Details |
Morgan | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in MO - H5421-210-0 Benefit Details |
New Madrid | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in MO - H5421-210-0 Benefit Details |
Pike | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in MO - H5421-210-0 Benefit Details |
Shelby | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in MO - H5421-210-0 Benefit Details |
Worth | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in MT - H5421-210-0 Benefit Details |
Deer Lodge | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in MT - H5421-210-0 Benefit Details |
Liberty | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in MT - H5421-210-0 Benefit Details |
Madison | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in MT - H5421-210-0 Benefit Details |
Teton | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in MT - H5421-210-0 Benefit Details |
Valley | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in NE - H5421-210-0 Benefit Details |
Arthur | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in NE - H5421-210-0 Benefit Details |
Chase | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in NE - H5421-210-0 Benefit Details |
Cherry | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in NE - H5421-210-0 Benefit Details |
Clay | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in NE - H5421-210-0 Benefit Details |
Fillmore | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in NE - H5421-210-0 Benefit Details |
Franklin | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in NE - H5421-210-0 Benefit Details |
Frontier | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in NE - H5421-210-0 Benefit Details |
Garden | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in NE - H5421-210-0 Benefit Details |
Harlan | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in NE - H5421-210-0 Benefit Details |
Hitchcock | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in NE - H5421-210-0 Benefit Details |
Howard | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in NE - H5421-210-0 Benefit Details |
Johnson | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in NE - H5421-210-0 Benefit Details |
Kimball | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in NE - H5421-210-0 Benefit Details |
Nemaha | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in NE - H5421-210-0 Benefit Details |
Pawnee | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in NE - H5421-210-0 Benefit Details |
Pierce | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in NE - H5421-210-0 Benefit Details |
Polk | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in NE - H5421-210-0 Benefit Details |
Red Willow | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in NE - H5421-210-0 Benefit Details |
Saline | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in NE - H5421-210-0 Benefit Details |
Sherman | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in NE - H5421-210-0 Benefit Details |
Thayer | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in NE - H5421-210-0 Benefit Details |
Valley | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in NV - H5421-210-0 Benefit Details |
Elko | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in NV - H5421-210-0 Benefit Details |
Humboldt | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in NV - H5421-210-0 Benefit Details |
Lincoln | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in NV - H5421-210-0 Benefit Details |
Storey | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in NC - H5421-210-0 Benefit Details |
Dare | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in NC - H5421-210-0 Benefit Details |
Swain | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in NC - H5421-210-0 Benefit Details |
Wilson | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in ND - H5421-210-0 Benefit Details |
Bowman | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in ND - H5421-210-0 Benefit Details |
Nelson | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in ND - H5421-210-0 Benefit Details |
Pierce | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in OK - H5421-210-0 Benefit Details |
Cherokee | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in OK - H5421-210-0 Benefit Details |
Custer | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in OK - H5421-210-0 Benefit Details |
Garfield | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in OK - H5421-210-0 Benefit Details |
Grant | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in OK - H5421-210-0 Benefit Details |
Harper | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in OK - H5421-210-0 Benefit Details |
Haskell | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in OK - H5421-210-0 Benefit Details |
Kiowa | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in OK - H5421-210-0 Benefit Details |
Latimer | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in OK - H5421-210-0 Benefit Details |
Love | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in OK - H5421-210-0 Benefit Details |
Major | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in OK - H5421-210-0 Benefit Details |
Murray | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in OK - H5421-210-0 Benefit Details |
Woodward | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in TN - H5421-210-0 Benefit Details |
Fentress | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in TX - H5421-210-0 Benefit Details |
Andrews | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in TX - H5421-210-0 Benefit Details |
Cochran | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in TX - H5421-210-0 Benefit Details |
Comanche | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in TX - H5421-210-0 Benefit Details |
Cottle | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in TX - H5421-210-0 Benefit Details |
Dallam | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in TX - H5421-210-0 Benefit Details |
Dawson | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in TX - H5421-210-0 Benefit Details |
Ector | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in TX - H5421-210-0 Benefit Details |
Erath | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in TX - H5421-210-0 Benefit Details |
Fannin | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in TX - H5421-210-0 Benefit Details |
Foard | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in TX - H5421-210-0 Benefit Details |
Gaines | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in TX - H5421-210-0 Benefit Details |
Goliad | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in TX - H5421-210-0 Benefit Details |
Jackson | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in TX - H5421-210-0 Benefit Details |
Karnes | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in TX - H5421-210-0 Benefit Details |
King | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in TX - H5421-210-0 Benefit Details |
Lavaca | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in TX - H5421-210-0 Benefit Details |
Matagorda | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in TX - H5421-210-0 Benefit Details |
Moore | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in TX - H5421-210-0 Benefit Details |
Motley | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in TX - H5421-210-0 Benefit Details |
Pecos | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in TX - H5421-210-0 Benefit Details |
Real | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in TX - H5421-210-0 Benefit Details |
Refugio | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in TX - H5421-210-0 Benefit Details |
Scurry | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in TX - H5421-210-0 Benefit Details |
Somervell | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in TX - H5421-210-0 Benefit Details |
Stonewall | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in TX - H5421-210-0 Benefit Details |
Swisher | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in TX - H5421-210-0 Benefit Details |
Victoria | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in TX - H5421-210-0 Benefit Details |
Wharton | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in TX - H5421-210-0 Benefit Details |
Young | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 200 (PFFS) in VA - H5421-210-0 Benefit Details |
Bath | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in VA - H5421-210-0 Benefit Details |
Westmoreland | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
Today's Options Premier 200 (PFFS) in WI - H5421-210-0 Benefit Details |
Walworth | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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