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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HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Alamance | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Alexander | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Alleghany | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Anson | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Ashe | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Avery | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Beaufort | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Bertie | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Bladen | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Brunswick | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Buncombe | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Burke | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Cabarrus | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Caldwell | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Camden | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Carteret | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Caswell | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Catawba | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
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 | |||||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Chatham | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Cherokee | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Chowan | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Clay | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Cleveland | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Columbus | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Craven | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Cumberland | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Currituck | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
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 | |||||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Dare | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Davidson | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Davie | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Duplin | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Durham | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Edgecombe | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Forsyth | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Franklin | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Gaston | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Gates | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Graham | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Granville | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Greene | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Guilford | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Halifax | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Harnett | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Haywood | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Henderson | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Hertford | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Hoke | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Hyde | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Iredell | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Jackson | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Johnston | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Jones | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Lee | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Lenoir | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Lincoln | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Macon | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Madison | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
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 | |||||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Martin | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
McDowell | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Mecklenburg | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Mitchell | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Montgomery | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Moore | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Nash | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
New Hanover | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Northampton | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
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 | |||||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Onslow | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Orange | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Pamlico | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Pasquotank | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Pender | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Perquimans | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Person | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Pitt | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Polk | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Randolph | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Richmond | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Robeson | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Rockingham | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Rowan | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Rutherford | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Sampson | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Scotland | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Stanly | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Stokes | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Surry | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Swain | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Transylvania | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Tyrrell | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Union | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Vance | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Wake | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Warren | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Washington | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Watauga | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Wayne | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Wilkes | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Wilson | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Yadkin | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in NC - R5826-063-0 Benefit Details |
Yancey | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Accomack | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Albemarle | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Alexandria City | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Alleghany | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Amelia | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Amherst | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Appomattox | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Arlington | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Augusta | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Bath | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Bedford | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Bedford City | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Bland | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Botetourt | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Bristol City | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Brunswick | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Buchanan | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Buckingham | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Buena Vista City | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Campbell | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Caroline | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Carroll | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Charles City | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Charlotte | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Charlottesville City | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Chesapeake City | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Chesterfield | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Clarke | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Clifton Forge City | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Colonial Heights City | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Covington City | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Craig | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Culpeper | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Cumberland | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Danville City | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Dickenson | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Dinwiddie | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Emporia City | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Essex | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Fairfax | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Fairfax City | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Falls Church City | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Fauquier | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Floyd | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Fluvanna | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Franklin | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Franklin City | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Frederick | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Fredericksburg City | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Galax City | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Giles | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Gloucester | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Goochland | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Grayson | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Greene | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Greensville | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Halifax | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Hampton City | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Hanover | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Harrisonburg City | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Henrico | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Henry | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Highland | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Hopewell City | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Isle of Wight | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
James City | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
King and Queen | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
King George | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
King William | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Lancaster | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Lee | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Lexington City | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Loudoun | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Louisa | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Lunenburg | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Lynchburg City | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Madison | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Manassas City | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Manassas Park City | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Martinsville City | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Mathews | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Mecklenburg | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Middlesex | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Montgomery | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Nelson | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
New Kent | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
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 | |||||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Newport News City | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Norfolk City | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Northampton | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
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 | |||||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Northumberland | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Norton City | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Nottoway | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Orange | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Page | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Patrick | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Petersburg City | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Pittsylvania | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Poquoson City | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Portsmouth City | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Powhatan | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Prince Edward | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Prince George | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Prince William | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Pulaski | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Radford City | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Rappahannock | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Richmond | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Richmond City | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Roanoke | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Roanoke City | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Rockbridge | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Rockingham | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Russell | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Salem City | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Scott | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Shenandoah | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Smyth | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
South Boston City | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Southampton | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Spotsylvania | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Stafford | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Staunton City | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Suffolk City | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Surry | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Sussex | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Tazewell | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Virginia Beach City | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Warren | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Washington | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Waynesboro City | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Westmoreland | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Williamsburg City | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Winchester City | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Wise | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
Wythe | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-063 (Regional PPO) in VA - R5826-063-0 Benefit Details |
York | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
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