ADEMPAS 2 MG TABLET (90 EA ) (NDC: 50419025301)
2016 Medicare Prescription Drug Plan (MAPD) Information
Click here for the Chart Legend |
Plan Name |
Monthly Prem. |
De- duct- ible |
Does Plan Offer Additional Gap Coverage |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Plan’s Avg. Retail Drug Price 30-Day |
Tier Nbr. |
Tier Desc. |
30-Day Prfrd. Pharm |
90-Day Mail Order |
BCN Advantage HMO-POS Basic (HMO-POS)
![Email Prescription and/or Health Benefit details for BCN Advantage HMO-POS Basic (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$360 |
to be determined |
5 |
Tier 5 |
25% | 25% | P | $9,120.88 |
Browse Plan Formulary |
BCN Advantage HMO-POS Basic (HMO-POS)
![Email Prescription and/or Health Benefit details for BCN Advantage HMO-POS Basic (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$360 |
to be determined |
5 |
Tier 5 |
25% | 25% | P | $9,120.88 |
Browse Plan Formulary |
BCN Advantage HMO-POS Basic (HMO-POS)
![Email Prescription and/or Health Benefit details for BCN Advantage HMO-POS Basic (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$360 |
to be determined |
5 |
Tier 5 |
25% | 25% | P | $9,120.88 |
Browse Plan Formulary |
BCN Advantage HMO-POS Basic (HMO-POS)
![Email Prescription and/or Health Benefit details for BCN Advantage HMO-POS Basic (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$360 |
to be determined |
5 |
Tier 5 |
25% | 25% | P | $9,120.88 |
Browse Plan Formulary |
BCN Advantage HMO-POS Basic (HMO-POS)
![Email Prescription and/or Health Benefit details for BCN Advantage HMO-POS Basic (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$360 |
to be determined |
5 |
Tier 5 |
25% | 25% | P | $9,120.88 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Harbor Medicare (HMO)
![Email Prescription and/or Health Benefit details for Harbor Medicare (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$240 |
to be determined |
5 |
Specialty Tier |
27% | n/a | P | $9,013.85 |
Browse Plan Formulary |
HealthPlus MedicarePlus Option 0 (HMO)
![Email Prescription and/or Health Benefit details for HealthPlus MedicarePlus Option 0 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$360 |
to be determined |
5 |
Specialty Tier |
25% | 25% | P Q:90 /30Days | $8,955.80 |
Browse Plan Formulary |
Meridian Prime (HMO)
![Email Prescription and/or Health Benefit details for Meridian Prime (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$100.00 | $200.00 | P | $8,984.10 |
Browse Plan Formulary |
PriorityMedicare Key (HMO-POS)
![Email Prescription and/or Health Benefit details for PriorityMedicare Key (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$360 |
to be determined |
5 |
Tier 5 |
25% | 25% | P Q:90 /30Days | $9,048.33 |
Browse Plan Formulary |
PriorityMedicare Key (HMO-POS)
![Email Prescription and/or Health Benefit details for PriorityMedicare Key (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$360 |
to be determined |
5 |
Tier 5 |
25% | 25% | P Q:90 /30Days | $9,048.33 |
Browse Plan Formulary |
PriorityMedicare Key (HMO-POS)
![Email Prescription and/or Health Benefit details for PriorityMedicare Key (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$360 |
to be determined |
5 |
Tier 5 |
25% | 25% | P Q:90 /30Days | $9,048.33 |
Browse Plan Formulary |
|
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
PriorityMedicare Key (HMO-POS)
![Email Prescription and/or Health Benefit details for PriorityMedicare Key (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$360 |
to be determined |
5 |
Tier 5 |
25% | 25% | P Q:90 /30Days | $9,048.33 |
Browse Plan Formulary |
PriorityMedicare Key (HMO-POS)
![Email Prescription and/or Health Benefit details for PriorityMedicare Key (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$360 |
to be determined |
5 |
Tier 5 |
25% | 25% | P Q:90 /30Days | $9,048.33 |
Browse Plan Formulary |
PriorityMedicare Ideal (PPO)
![Email Prescription and/or Health Benefit details for PriorityMedicare Ideal (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$15.00 |
$360 |
to be determined |
5 |
Tier 5 |
25% | 25% | P Q:90 /30Days | $9,048.33 |
Browse Plan Formulary |
PriorityMedicare Ideal (PPO)
![Email Prescription and/or Health Benefit details for PriorityMedicare Ideal (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$15.00 |
$360 |
to be determined |
5 |
Tier 5 |
25% | 25% | P Q:90 /30Days | $9,048.33 |
Browse Plan Formulary |
PriorityMedicare Ideal (PPO)
![Email Prescription and/or Health Benefit details for PriorityMedicare Ideal (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$15.00 |
$360 |
to be determined |
5 |
Tier 5 |
25% | 25% | P Q:90 /30Days | $9,048.33 |
Browse Plan Formulary |
PriorityMedicare Ideal (PPO)
![Email Prescription and/or Health Benefit details for PriorityMedicare Ideal (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$15.00 |
$360 |
to be determined |
5 |
Tier 5 |
25% | 25% | P Q:90 /30Days | $9,048.33 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
PriorityMedicare Ideal (PPO)
![Email Prescription and/or Health Benefit details for PriorityMedicare Ideal (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$15.00 |
$360 |
to be determined |
5 |
Tier 5 |
25% | 25% | P Q:90 /30Days | $9,048.33 |
Browse Plan Formulary |
Medicare Plus Blue PPO Essential (PPO)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue PPO Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.50 |
$360 |
to be determined |
5 |
Tier 5 |
25% | 25% | P | $9,120.88 |
Browse Plan Formulary |
Medicare Plus Blue PPO Essential (PPO)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue PPO Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.50 |
$360 |
to be determined |
5 |
Tier 5 |
25% | 25% | P | $9,120.88 |
Browse Plan Formulary |
Medicare Plus Blue PPO Essential (PPO)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue PPO Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.50 |
$360 |
to be determined |
5 |
Tier 5 |
25% | 25% | P | $9,120.88 |
Browse Plan Formulary |
Medicare Plus Blue PPO Essential (PPO)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue PPO Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.50 |
$360 |
to be determined |
5 |
Tier 5 |
25% | 25% | P | $9,120.88 |
Browse Plan Formulary |
Medicare Plus Blue PPO Essential (PPO)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue PPO Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.50 |
$360 |
to be determined |
5 |
Tier 5 |
25% | 25% | P | $9,120.88 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
McLaren Advantage Sapphire (HMO)
![Email Prescription and/or Health Benefit details for McLaren Advantage Sapphire (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$150 |
to be determined |
4 |
Specialty Tier |
29% | n/a | P Q:90 /30Days | $8,886.06 |
Browse Plan Formulary |
McLaren Advantage Sapphire (HMO)
![Email Prescription and/or Health Benefit details for McLaren Advantage Sapphire (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$150 |
to be determined |
4 |
Specialty Tier |
29% | n/a | P Q:90 /30Days | $8,886.06 |
Browse Plan Formulary |
Erickson Advantage Guardian (HMO-POS SNP)
![Email Prescription and/or Health Benefit details for Erickson Advantage Guardian (HMO-POS SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.10 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | 33% | P | $8,989.90 |
Browse Plan Formulary |
Molina Medicare Options Plus (HMO SNP)
![Email Prescription and/or Health Benefit details for Molina Medicare Options Plus (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$360 |
to be determined |
5 |
Specialty Tier |
25% | n/a | P Q:90 /30Days | $9,290.06 |
Browse Plan Formulary |
HAP Midwest Health Plan (HMO SNP)
![Email Prescription and/or Health Benefit details for HAP Midwest Health Plan (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$360 |
to be determined |
2 |
Brand |
25% | n/a | P Q:90 /30Days | $8,986.93 |
Browse Plan Formulary |
Meridian Advantage Plan of Michigan (HMO SNP)
![Email Prescription and/or Health Benefit details for Meridian Advantage Plan of Michigan (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$360 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | P | $8,984.10 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
BCN Advantage HMO ConnectedCare (HMO)
![Email Prescription and/or Health Benefit details for BCN Advantage HMO ConnectedCare (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | n/a | P | $9,120.88 |
Browse Plan Formulary |
Harbor Medicare Select (HMO)
![Email Prescription and/or Health Benefit details for Harbor Medicare Select (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | n/a | P | $9,013.85 |
Browse Plan Formulary |
Erickson Advantage Freedom (HMO-POS)
![Email Prescription and/or Health Benefit details for Erickson Advantage Freedom (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | 33% | P | $8,989.90 |
Browse Plan Formulary |
HAP Senior Plus - Expanded Network (HMO-POS)
![Email Prescription and/or Health Benefit details for HAP Senior Plus - Expanded Network (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$59.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | 33% | P | $8,824.07 |
Browse Plan Formulary |
McLaren Advantage Diamond (HMO)
![Email Prescription and/or Health Benefit details for McLaren Advantage Diamond (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$63.00 |
$150 |
to be determined |
4 |
Specialty Tier |
29% | n/a | P Q:90 /30Days | $8,886.06 |
Browse Plan Formulary |
McLaren Advantage Diamond (HMO)
![Email Prescription and/or Health Benefit details for McLaren Advantage Diamond (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$63.00 |
$150 |
to be determined |
4 |
Specialty Tier |
29% | n/a | P Q:90 /30Days | $8,886.06 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
PriorityMedicare Value (HMO-POS)
![Email Prescription and/or Health Benefit details for PriorityMedicare Value (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$66.00 |
$75 |
to be determined |
5 |
Tier 5 |
31% | n/a | P Q:90 /30Days | $9,048.33 |
Browse Plan Formulary |
HAP Senior Plus - Henry Ford (HMO)
![Email Prescription and/or Health Benefit details for HAP Senior Plus - Henry Ford (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$79.00 |
$200 |
to be determined |
5 |
Specialty Tier |
28% | 28% | P | $8,824.07 |
Browse Plan Formulary |
Humana Gold Plus H8908-001 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H8908-001 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$89.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | n/a | P Q:90 /30Days | $8,916.62 |
Browse Plan Formulary |
PriorityMedicare Merit (PPO)
![Email Prescription and/or Health Benefit details for PriorityMedicare Merit (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$95.00 |
$75 |
to be determined |
5 |
Tier 5 |
31% | n/a | P Q:90 /30Days | $9,048.33 |
Browse Plan Formulary |
PriorityMedicare Merit (PPO)
![Email Prescription and/or Health Benefit details for PriorityMedicare Merit (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$95.00 |
$75 |
to be determined |
5 |
Tier 5 |
31% | n/a | P Q:90 /30Days | $9,048.33 |
Browse Plan Formulary |
PriorityMedicare Merit (PPO)
![Email Prescription and/or Health Benefit details for PriorityMedicare Merit (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$95.00 |
$75 |
to be determined |
5 |
Tier 5 |
31% | n/a | P Q:90 /30Days | $9,048.33 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
PriorityMedicare Merit (PPO)
![Email Prescription and/or Health Benefit details for PriorityMedicare Merit (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$95.00 |
$75 |
to be determined |
5 |
Tier 5 |
31% | n/a | P Q:90 /30Days | $9,048.33 |
Browse Plan Formulary |
PriorityMedicare Merit (PPO)
![Email Prescription and/or Health Benefit details for PriorityMedicare Merit (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$95.00 |
$75 |
to be determined |
5 |
Tier 5 |
31% | n/a | P Q:90 /30Days | $9,048.33 |
Browse Plan Formulary |
HealthPlus MedicarePlus Option 1 (HMO)
![Email Prescription and/or Health Benefit details for HealthPlus MedicarePlus Option 1 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$98.00 |
$100* |
to be determined |
5* |
Specialty Tier |
30% | 30% | P Q:90 /30Days | $8,955.80 |
Browse Plan Formulary |
Medicare Plus Blue PPO Vitality (PPO)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue PPO Vitality (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$106.00 |
$360 |
to be determined |
5 |
Tier 5 |
25% | 25% | P | $9,120.88 |
Browse Plan Formulary |
Medicare Plus Blue PPO Vitality (PPO)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue PPO Vitality (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$106.00 |
$360 |
to be determined |
5 |
Tier 5 |
25% | 25% | P | $9,120.88 |
Browse Plan Formulary |
Medicare Plus Blue PPO Vitality (PPO)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue PPO Vitality (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$106.00 |
$360 |
to be determined |
5 |
Tier 5 |
25% | 25% | P | $9,120.88 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue PPO Vitality (PPO)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue PPO Vitality (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$106.00 |
$360 |
to be determined |
5 |
Tier 5 |
25% | 25% | P | $9,120.88 |
Browse Plan Formulary |
Medicare Plus Blue PPO Vitality (PPO)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue PPO Vitality (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$106.00 |
$360 |
to be determined |
5 |
Tier 5 |
25% | 25% | P | $9,120.88 |
Browse Plan Formulary |
HAP Senior Plus - Expanded Network (HMO-POS)
![Email Prescription and/or Health Benefit details for HAP Senior Plus - Expanded Network (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$109.00 |
$100 |
to be determined |
5 |
Specialty Tier |
30% | 30% | P | $8,824.07 |
Browse Plan Formulary |
HumanaChoice R5826-006 (Regional PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice R5826-006 (Regional PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$121.00 |
$360 |
to be determined |
5 |
Tier 5 |
25% | 25% | P Q:90 /30Days | $8,916.62 |
Browse Plan Formulary |
Alliance Medicare PPO (PPO)
![Email Prescription and/or Health Benefit details for Alliance Medicare PPO (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$126.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | 33% | P | $8,824.07 |
Browse Plan Formulary |
PriorityMedicare (HMO-POS)
![Email Prescription and/or Health Benefit details for PriorityMedicare (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$146.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P Q:90 /30Days | $9,048.33 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
BCN Advantage HMO-POS Classic (HMO-POS)
![Email Prescription and/or Health Benefit details for BCN Advantage HMO-POS Classic (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$154.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | n/a | P | $9,120.88 |
Browse Plan Formulary |
BCN Advantage HMO-POS Classic (HMO-POS)
![Email Prescription and/or Health Benefit details for BCN Advantage HMO-POS Classic (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$154.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | n/a | P | $9,120.88 |
Browse Plan Formulary |
BCN Advantage HMO-POS Classic (HMO-POS)
![Email Prescription and/or Health Benefit details for BCN Advantage HMO-POS Classic (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$154.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | n/a | P | $9,120.88 |
Browse Plan Formulary |
BCN Advantage HMO-POS Classic (HMO-POS)
![Email Prescription and/or Health Benefit details for BCN Advantage HMO-POS Classic (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$154.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | n/a | P | $9,120.88 |
Browse Plan Formulary |
BCN Advantage HMO-POS Classic (HMO-POS)
![Email Prescription and/or Health Benefit details for BCN Advantage HMO-POS Classic (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$154.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | n/a | P | $9,120.88 |
Browse Plan Formulary |
Medicare Plus Blue PPO Signature (PPO)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue PPO Signature (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$169.00 |
$100 |
to be determined |
5 |
Specialty Tier |
30% | n/a | P | $9,120.88 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue PPO Signature (PPO)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue PPO Signature (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$169.00 |
$100 |
to be determined |
5 |
Specialty Tier |
30% | n/a | P | $9,120.88 |
Browse Plan Formulary |
Medicare Plus Blue PPO Signature (PPO)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue PPO Signature (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$169.00 |
$100 |
to be determined |
5 |
Specialty Tier |
30% | n/a | P | $9,120.88 |
Browse Plan Formulary |
Medicare Plus Blue PPO Signature (PPO)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue PPO Signature (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$169.00 |
$100 |
to be determined |
5 |
Specialty Tier |
30% | n/a | P | $9,120.88 |
Browse Plan Formulary |
Medicare Plus Blue PPO Signature (PPO)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue PPO Signature (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$169.00 |
$100 |
to be determined |
5 |
Specialty Tier |
30% | n/a | P | $9,120.88 |
Browse Plan Formulary |
Erickson Advantage Champion (HMO-POS SNP)
![Email Prescription and/or Health Benefit details for Erickson Advantage Champion (HMO-POS SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$190.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | 33% | P | $8,989.90 |
Browse Plan Formulary |
Erickson Advantage Signature with Drugs (HMO-POS)
![Email Prescription and/or Health Benefit details for Erickson Advantage Signature with Drugs (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$190.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | 33% | P | $8,989.90 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
PriorityMedicare Select (PPO)
![Email Prescription and/or Health Benefit details for PriorityMedicare Select (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$193.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P Q:90 /30Days | $9,048.33 |
Browse Plan Formulary |
PriorityMedicare Select (PPO)
![Email Prescription and/or Health Benefit details for PriorityMedicare Select (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$193.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P Q:90 /30Days | $9,048.33 |
Browse Plan Formulary |
PriorityMedicare Select (PPO)
![Email Prescription and/or Health Benefit details for PriorityMedicare Select (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$193.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P Q:90 /30Days | $9,048.33 |
Browse Plan Formulary |
PriorityMedicare Select (PPO)
![Email Prescription and/or Health Benefit details for PriorityMedicare Select (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$193.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P Q:90 /30Days | $9,048.33 |
Browse Plan Formulary |
PriorityMedicare Select (PPO)
![Email Prescription and/or Health Benefit details for PriorityMedicare Select (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$193.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P Q:90 /30Days | $9,048.33 |
Browse Plan Formulary |
Alliance Medicare PPO (PPO)
![Email Prescription and/or Health Benefit details for Alliance Medicare PPO (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$210.00 |
$150 |
to be determined |
5 |
Specialty Tier |
29% | 29% | P | $8,824.07 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HAP Senior Plus - Expanded Network (HMO-POS)
![Email Prescription and/or Health Benefit details for HAP Senior Plus - Expanded Network (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$220.00 |
$50 |
to be determined |
5 |
Specialty Tier |
31% | 31% | P | $8,824.07 |
Browse Plan Formulary |
BCN Advantage HMO-POS Prestige (HMO-POS)
![Email Prescription and/or Health Benefit details for BCN Advantage HMO-POS Prestige (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$283.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | n/a | P | $9,120.88 |
Browse Plan Formulary |
BCN Advantage HMO-POS Prestige (HMO-POS)
![Email Prescription and/or Health Benefit details for BCN Advantage HMO-POS Prestige (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$283.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | n/a | P | $9,120.88 |
Browse Plan Formulary |
BCN Advantage HMO-POS Prestige (HMO-POS)
![Email Prescription and/or Health Benefit details for BCN Advantage HMO-POS Prestige (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$283.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | n/a | P | $9,120.88 |
Browse Plan Formulary |
BCN Advantage HMO-POS Prestige (HMO-POS)
![Email Prescription and/or Health Benefit details for BCN Advantage HMO-POS Prestige (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$283.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | n/a | P | $9,120.88 |
Browse Plan Formulary |
BCN Advantage HMO-POS Prestige (HMO-POS)
![Email Prescription and/or Health Benefit details for BCN Advantage HMO-POS Prestige (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$283.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | n/a | P | $9,120.88 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue PPO Assure (PPO)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue PPO Assure (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$294.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | n/a | P | $9,120.88 |
Browse Plan Formulary |
Medicare Plus Blue PPO Assure (PPO)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue PPO Assure (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$294.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | n/a | P | $9,120.88 |
Browse Plan Formulary |
Medicare Plus Blue PPO Assure (PPO)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue PPO Assure (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$294.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | n/a | P | $9,120.88 |
Browse Plan Formulary |
Medicare Plus Blue PPO Assure (PPO)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue PPO Assure (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$294.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | n/a | P | $9,120.88 |
Browse Plan Formulary |
Medicare Plus Blue PPO Assure (PPO)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue PPO Assure (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$294.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | n/a | P | $9,120.88 |
Browse Plan Formulary |