2013 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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Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Anderson | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Bandera | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Bastrop | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Bee | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Bexar | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Blanco | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Bosque | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Brazos | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Burleson | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Burnet | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Caldwell | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Cameron | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Camp | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Cherokee | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Coke | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Coleman | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Collin | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Colorado | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Comal | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Cooke | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Dallas | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Denton | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
DeWitt | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
El Paso | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Falls | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Fayette | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Floyd | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Fort Bend | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Franklin | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Freestone | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Frio | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Garza | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Gillespie | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Guadalupe | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Hamilton | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Hardin | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Harris | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Hays | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Henderson | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Hidalgo | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Hill | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Hood | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Houston | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Jackson | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Jefferson | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Jim Wells | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Johnson | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Kendall | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Kerr | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Kleberg | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Lamb | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Lee | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Llano | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Lubbock | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Lynn | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Marion | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Mason | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
McLennan | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Medina | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Midland | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Montgomery | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Newton | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Nueces | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Orange | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Polk | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Potter | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Rains | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Randall | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Refugio | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Rockwall | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
San Jacinto | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Shelby | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Smith | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Swisher | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Tarrant | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Taylor | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Terry | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Tom Green | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Travis | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Trinity | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Tyler | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Van Zandt | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Victoria | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Walker | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Washington | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Webb | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Wharton | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Willacy | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Williamson | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Wilson | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Wise | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Wood | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-084 (PFFS) in TX - H8145-084-0 Benefit Details |
Zavala | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
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