NEULASTA 6MG/0.6ML SYRINGE (6 MG IN 0.6 ML SYR) (NDC: 55513019001)
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 |
AARP MedicareComplete SecureHorizons Plan 1 (HMO)
![Email Prescription and/or Health Benefit details for AARP MedicareComplete SecureHorizons Plan 1 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | 33% | P | $5,408.50 |
Browse Plan Formulary |
AARP MedicareComplete SecureHorizons Plan 1 (HMO)
![Email Prescription and/or Health Benefit details for AARP MedicareComplete SecureHorizons Plan 1 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | 33% | P | $5,408.50 |
Browse Plan Formulary |
AARP MedicareComplete SecureHorizons Plan 2 (HMO)
![Email Prescription and/or Health Benefit details for AARP MedicareComplete SecureHorizons Plan 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | 33% | P | $5,408.50 |
Browse Plan Formulary |
AARP MedicareComplete SecureHorizons Plan 2 (HMO)
![Email Prescription and/or Health Benefit details for AARP MedicareComplete SecureHorizons Plan 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | 33% | P | $5,408.50 |
Browse Plan Formulary |
Blue Shield 65 Plus (HMO)
![Email Prescription and/or Health Benefit details for Blue Shield 65 Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
6 |
Specialty Tier |
33% | n/a | P | $5,335.99 |
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 |
Blue Shield 65 Plus (HMO)
![Email Prescription and/or Health Benefit details for Blue Shield 65 Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
6 |
Specialty Tier |
33% | n/a | P | $5,335.99 |
Browse Plan Formulary |
Blue Shield 65 Plus Choice Plan (HMO)
![Email Prescription and/or Health Benefit details for Blue Shield 65 Plus Choice Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
6 |
Tier 6 |
33% | n/a | P | $5,335.99 |
Browse Plan Formulary |
Bridges Drug Savings (HMO SNP)
![Email Prescription and/or Health Benefit details for Bridges Drug Savings (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | 33% | None | $5,391.02 |
Browse Plan Formulary |
Bridges Drug Savings (HMO SNP)
![Email Prescription and/or Health Benefit details for Bridges Drug Savings (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | 33% | None | $5,391.02 |
Browse Plan Formulary |
Care1st AdvantageOptimum Plan (HMO)
![Email Prescription and/or Health Benefit details for Care1st AdvantageOptimum Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | 33% | P | $5,425.99 |
Browse Plan Formulary |
Care1st AdvantageOptimum Plan (HMO)
![Email Prescription and/or Health Benefit details for Care1st AdvantageOptimum Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | 33% | P | $5,425.99 |
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 |
Care1st Cal MediConnect Plan (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Care1st Cal MediConnect Plan (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Brand Drugs |
0% | 0% | P | $5,426.19 |
Browse Plan Formulary |
Care1st Cal MediConnect Plan (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Care1st Cal MediConnect Plan (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Brand Drugs |
0% | 0% | P | $5,426.19 |
Browse Plan Formulary |
CareMore Breathe (HMO SNP)
![Email Prescription and/or Health Benefit details for CareMore Breathe (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P Q:2 /28Days | $5,582.87 |
Browse Plan Formulary |
CareMore Breathe (HMO SNP)
![Email Prescription and/or Health Benefit details for CareMore Breathe (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P Q:2 /28Days | $5,582.87 |
Browse Plan Formulary |
CareMore Cal MediConnect Medicare-Medicaid Plan (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for CareMore Cal MediConnect Medicare-Medicaid Plan (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
0% | 0% | P Q:2 /28Days | $5,582.87 |
Browse Plan Formulary |
CareMore Cal MediConnect Medicare-Medicaid Plan (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for CareMore Cal MediConnect Medicare-Medicaid Plan (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
0% | 0% | P Q:2 /28Days | $5,582.87 |
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 |
CareMore Connect (HMO SNP)
![Email Prescription and/or Health Benefit details for CareMore Connect (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$360 |
to be determined |
5 |
Tier 5 |
25% | n/a | P Q:2 /28Days | $5,582.87 |
Browse Plan Formulary |
CareMore Connect (HMO SNP)
![Email Prescription and/or Health Benefit details for CareMore Connect (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$360 |
to be determined |
5 |
Tier 5 |
25% | n/a | P Q:2 /28Days | $5,582.87 |
Browse Plan Formulary |
CareMore ESRD (HMO SNP)
![Email Prescription and/or Health Benefit details for CareMore ESRD (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P Q:2 /28Days | $5,582.87 |
Browse Plan Formulary |
CareMore ESRD (HMO SNP)
![Email Prescription and/or Health Benefit details for CareMore ESRD (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P Q:2 /28Days | $5,582.87 |
Browse Plan Formulary |
CareMore Heart (HMO SNP)
![Email Prescription and/or Health Benefit details for CareMore Heart (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P Q:2 /28Days | $5,582.87 |
Browse Plan Formulary |
CareMore Heart (HMO SNP)
![Email Prescription and/or Health Benefit details for CareMore Heart (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P Q:2 /28Days | $5,582.87 |
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 |
CareMore Reliance (HMO SNP)
![Email Prescription and/or Health Benefit details for CareMore Reliance (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P Q:2 /28Days | $5,582.87 |
Browse Plan Formulary |
CareMore Reliance (HMO SNP)
![Email Prescription and/or Health Benefit details for CareMore Reliance (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P Q:2 /28Days | $5,582.87 |
Browse Plan Formulary |
CareMore StartSmart Plus (HMO)
![Email Prescription and/or Health Benefit details for CareMore StartSmart Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P Q:2 /28Days | $5,582.87 |
Browse Plan Formulary |
CareMore StartSmart Plus (HMO)
![Email Prescription and/or Health Benefit details for CareMore StartSmart Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P Q:2 /28Days | $5,582.87 |
Browse Plan Formulary |
CareMore Touch (HMO SNP)
![Email Prescription and/or Health Benefit details for CareMore Touch (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P Q:2 /28Days | $5,582.87 |
Browse Plan Formulary |
CareMore Touch (HMO SNP)
![Email Prescription and/or Health Benefit details for CareMore Touch (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P Q:2 /28Days | $5,582.87 |
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 |
CareMore Value Plus (HMO)
![Email Prescription and/or Health Benefit details for CareMore Value Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P Q:2 /28Days | $5,582.87 |
Browse Plan Formulary |
CareMore Value Plus (HMO)
![Email Prescription and/or Health Benefit details for CareMore Value Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P Q:2 /28Days | $5,582.87 |
Browse Plan Formulary |
Central Health Focus Plan (HMO SNP)
![Email Prescription and/or Health Benefit details for Central Health Focus Plan (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | n/a | P Q:2 /30Days | $5,582.87 |
Browse Plan Formulary |
Central Health Focus Plan (HMO SNP)
![Email Prescription and/or Health Benefit details for Central Health Focus Plan (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | n/a | P Q:2 /30Days | $5,582.87 |
Browse Plan Formulary |
Central Health Medicare Plan (HMO)
![Email Prescription and/or Health Benefit details for Central Health Medicare Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | n/a | P Q:2 /30Days | $5,582.87 |
Browse Plan Formulary |
Central Health Medicare Plan (HMO)
![Email Prescription and/or Health Benefit details for Central Health Medicare Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | n/a | P Q:2 /30Days | $5,582.87 |
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 |
Classic Care (HMO)
![Email Prescription and/or Health Benefit details for Classic Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | 33% | None | $5,391.02 |
Browse Plan Formulary |
Classic Care (HMO)
![Email Prescription and/or Health Benefit details for Classic Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | 33% | None | $5,391.02 |
Browse Plan Formulary |
Easy Choice Best Plan (HMO)
![Email Prescription and/or Health Benefit details for Easy Choice Best Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | n/a | P | $5,510.51 |
Browse Plan Formulary |
Easy Choice Best Plan (HMO)
![Email Prescription and/or Health Benefit details for Easy Choice Best Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | n/a | P | $5,510.51 |
Browse Plan Formulary |
Golden State Medicare Health Plan, Golden (HMO)
![Email Prescription and/or Health Benefit details for Golden State Medicare Health Plan, Golden (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | 33% | P | $5,405.32 |
Browse Plan Formulary |
Health Net Cal MediConnect Plan (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Health Net Cal MediConnect Plan (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Brand Drugs |
0% | 0% | P | $5,503.52 |
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 |
Health Net Cal MediConnect Plan (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Health Net Cal MediConnect Plan (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Brand Drugs |
0% | 0% | P | $5,503.52 |
Browse Plan Formulary |
Health Net Gold Select (HMO)
![Email Prescription and/or Health Benefit details for Health Net Gold Select (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | 33% | P | $5,504.29 |
Browse Plan Formulary |
Health Net Gold Select (HMO)
![Email Prescription and/or Health Benefit details for Health Net Gold Select (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | 33% | P | $5,508.97 |
Browse Plan Formulary |
Health Net Gold Select (HMO)
![Email Prescription and/or Health Benefit details for Health Net Gold Select (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | 33% | P | $5,504.29 |
Browse Plan Formulary |
Health Net Gold Select (HMO)
![Email Prescription and/or Health Benefit details for Health Net Gold Select (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | 33% | P | $5,508.97 |
Browse Plan Formulary |
Health Net Jade (HMO SNP)
![Email Prescription and/or Health Benefit details for Health Net Jade (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | 33% | P | $5,509.07 |
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 |
Health Net Jade (HMO SNP)
![Email Prescription and/or Health Benefit details for Health Net Jade (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | 33% | P | $5,509.07 |
Browse Plan Formulary |
Healthy Heart Drug Savings (HMO SNP)
![Email Prescription and/or Health Benefit details for Healthy Heart Drug Savings (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | 33% | None | $5,391.02 |
Browse Plan Formulary |
Healthy Heart Drug Savings (HMO SNP)
![Email Prescription and/or Health Benefit details for Healthy Heart Drug Savings (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | 33% | None | $5,391.02 |
Browse Plan Formulary |
Heart & Diabetes (HMO SNP)
![Email Prescription and/or Health Benefit details for Heart & Diabetes (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | n/a | P | $5,482.37 |
Browse Plan Formulary |
Heart & Diabetes (HMO SNP)
![Email Prescription and/or Health Benefit details for Heart & Diabetes (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | n/a | P | $5,482.37 |
Browse Plan Formulary |
Hope Drug Savings (HMO SNP)
![Email Prescription and/or Health Benefit details for Hope Drug Savings (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | 33% | None | $5,391.02 |
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 |
Hope Drug Savings (HMO SNP)
![Email Prescription and/or Health Benefit details for Hope Drug Savings (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | 33% | None | $5,391.02 |
Browse Plan Formulary |
Humana Gold Plus H5619-021 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H5619-021 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | n/a | P Q:1 /28Days | $5,406.92 |
Browse Plan Formulary |
Humana Gold Plus H5619-021 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H5619-021 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | n/a | P Q:1 /28Days | $5,406.92 |
Browse Plan Formulary |
In Control Drug Savings (HMO SNP)
![Email Prescription and/or Health Benefit details for In Control Drug Savings (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | 33% | None | $5,391.02 |
Browse Plan Formulary |
In Control Drug Savings (HMO SNP)
![Email Prescription and/or Health Benefit details for In Control Drug Savings (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | 33% | None | $5,391.02 |
Browse Plan Formulary |
Inter Valley Health Plan Service To Seniors (HMO)
![Email Prescription and/or Health Benefit details for Inter Valley Health Plan Service To Seniors (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P Q:2 /30Days | $5,582.87 |
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 |
Kaiser Permanente Senior Advantage B Only South (HMO)
![Email Prescription and/or Health Benefit details for Kaiser Permanente Senior Advantage B Only South (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
25% | 25% | None | $5,715.12 |
Browse Plan Formulary |
Kaiser Permanente Senior Advantage B Only South (HMO)
![Email Prescription and/or Health Benefit details for Kaiser Permanente Senior Advantage B Only South (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
25% | 25% | None | $5,715.12 |
Browse Plan Formulary |
Kaiser Permanente Senior Advantage LA, Orange Co. (HMO)
![Email Prescription and/or Health Benefit details for Kaiser Permanente Senior Advantage LA, Orange Co. (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Specialty Tier |
25% | 25% | None | $5,695.20 |
Browse Plan Formulary |
Kaiser Permanente Senior Advantage LA, Orange Co. (HMO)
![Email Prescription and/or Health Benefit details for Kaiser Permanente Senior Advantage LA, Orange Co. (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Specialty Tier |
25% | 25% | None | $5,695.20 |
Browse Plan Formulary |
L.A Care Cal MediConnect Plan (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for L.A Care Cal MediConnect Plan (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Brand Drugs |
0% | 0% | P | $5,412.53 |
Browse Plan Formulary |
L.A Care Cal MediConnect Plan (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for L.A Care Cal MediConnect Plan (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Brand Drugs |
0% | 0% | P | $5,412.53 |
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 |
My Choice Plan (HMO)
![Email Prescription and/or Health Benefit details for My Choice Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | n/a | P | $5,481.89 |
Browse Plan Formulary |
My Choice Plan (HMO)
![Email Prescription and/or Health Benefit details for My Choice Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | n/a | P | $5,481.89 |
Browse Plan Formulary |
PHP (HMO SNP)
![Email Prescription and/or Health Benefit details for PHP (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$360 |
to be determined |
4 |
Specialty Tier |
25% | n/a | None | $5,426.35 |
Browse Plan Formulary |
PHP (HMO SNP)
![Email Prescription and/or Health Benefit details for PHP (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$360 |
to be determined |
4 |
Specialty Tier |
25% | n/a | None | $5,426.35 |
Browse Plan Formulary |
Platinum Plan (HMO)
![Email Prescription and/or Health Benefit details for Platinum Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | n/a | P | $5,482.37 |
Browse Plan Formulary |
Platinum Plan (HMO)
![Email Prescription and/or Health Benefit details for Platinum Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | n/a | P | $5,482.37 |
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 |
Easy Choice Plus Plan (HMO)
![Email Prescription and/or Health Benefit details for Easy Choice Plus Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.00 |
$360 |
to be determined |
5 |
Specialty Tier |
25% | n/a | P | $5,510.51 |
Browse Plan Formulary |
Easy Choice Plus Plan (HMO)
![Email Prescription and/or Health Benefit details for Easy Choice Plus Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.00 |
$360 |
to be determined |
5 |
Specialty Tier |
25% | n/a | P | $5,510.51 |
Browse Plan Formulary |
Health Net Healthy Heart (HMO)
![Email Prescription and/or Health Benefit details for Health Net Healthy Heart (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | 33% | P | $5,504.29 |
Browse Plan Formulary |
Health Net Healthy Heart (HMO)
![Email Prescription and/or Health Benefit details for Health Net Healthy Heart (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | 33% | P | $5,508.97 |
Browse Plan Formulary |
Health Net Healthy Heart (HMO)
![Email Prescription and/or Health Benefit details for Health Net Healthy Heart (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | 33% | P | $5,504.29 |
Browse Plan Formulary |
Health Net Healthy Heart (HMO)
![Email Prescription and/or Health Benefit details for Health Net Healthy Heart (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | 33% | P | $5,508.97 |
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 |
CareMore Connect Plus (HMO)
![Email Prescription and/or Health Benefit details for CareMore Connect Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$360 |
to be determined |
5 |
Tier 5 |
25% | 25% | P Q:2 /28Days | $5,582.87 |
Browse Plan Formulary |
CareMore Connect Plus (HMO)
![Email Prescription and/or Health Benefit details for CareMore Connect Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$360 |
to be determined |
5 |
Tier 5 |
25% | 25% | P Q:2 /28Days | $5,582.87 |
Browse Plan Formulary |
Humana Gold Plus H5619-037 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H5619-037 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.40 |
$360 |
to be determined |
5 |
Specialty Tier |
25% | n/a | P Q:1 /28Days | $5,407.04 |
Browse Plan Formulary |
Humana Gold Plus H5619-037 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H5619-037 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.40 |
$360 |
to be determined |
5 |
Specialty Tier |
25% | n/a | P Q:1 /28Days | $5,407.04 |
Browse Plan Formulary |
Senior Advantage Medicare Medi-Cal Plan South (HMO SNP)
![Email Prescription and/or Health Benefit details for Senior Advantage Medicare Medi-Cal Plan South (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.20 |
$0 |
to be determined |
5 |
Specialty Tier |
25% | 25% | None | $5,715.12 |
Browse Plan Formulary |
Senior Advantage Medicare Medi-Cal Plan South (HMO SNP)
![Email Prescription and/or Health Benefit details for Senior Advantage Medicare Medi-Cal Plan South (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.20 |
$0 |
to be determined |
5 |
Specialty Tier |
25% | 25% | None | $5,715.12 |
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 |
AARP MedicareComplete SecureHorizons Plan 3 (HMO)
![Email Prescription and/or Health Benefit details for AARP MedicareComplete SecureHorizons Plan 3 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.40 |
$360 |
to be determined |
5 |
Tier 5 |
25% | 25% | P | $5,410.10 |
Browse Plan Formulary |
AARP MedicareComplete SecureHorizons Plan 3 (HMO)
![Email Prescription and/or Health Benefit details for AARP MedicareComplete SecureHorizons Plan 3 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.40 |
$360 |
to be determined |
5 |
Tier 5 |
25% | 25% | P | $5,410.10 |
Browse Plan Formulary |
Bridges - Dual Access (HMO SNP)
![Email Prescription and/or Health Benefit details for Bridges - Dual Access (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.00 |
$360 |
to be determined |
5 |
Specialty Tier |
25% | 25% | None | $5,391.02 |
Browse Plan Formulary |
Bridges - Dual Access (HMO SNP)
![Email Prescription and/or Health Benefit details for Bridges - Dual Access (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.00 |
$360 |
to be determined |
5 |
Specialty Tier |
25% | 25% | None | $5,391.02 |
Browse Plan Formulary |
CalPlus Plan (HMO)
![Email Prescription and/or Health Benefit details for CalPlus Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.00 |
$360 |
to be determined |
5 |
Tier 5 |
25% | 25% | P | $5,481.67 |
Browse Plan Formulary |
CalPlus Plan (HMO)
![Email Prescription and/or Health Benefit details for CalPlus Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.00 |
$360 |
to be determined |
5 |
Tier 5 |
25% | 25% | P | $5,481.67 |
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 |
Care1st TotalDual Plan (HMO SNP)
![Email Prescription and/or Health Benefit details for Care1st TotalDual Plan (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.00 |
$360 |
to be determined |
5 |
Specialty Tier |
25% | 25% | P | $5,426.19 |
Browse Plan Formulary |
Care1st TotalDual Plan (HMO SNP)
![Email Prescription and/or Health Benefit details for Care1st TotalDual Plan (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.00 |
$360 |
to be determined |
5 |
Specialty Tier |
25% | 25% | P | $5,426.19 |
Browse Plan Formulary |
Classic Choice for Medi-Medi (HMO)
![Email Prescription and/or Health Benefit details for Classic Choice for Medi-Medi (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.00 |
$360 |
to be determined |
5 |
Specialty Tier |
25% | 25% | None | $5,391.02 |
Browse Plan Formulary |
Classic Choice for Medi-Medi (HMO)
![Email Prescription and/or Health Benefit details for Classic Choice for Medi-Medi (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.00 |
$360 |
to be determined |
5 |
Specialty Tier |
25% | 25% | None | $5,391.02 |
Browse Plan Formulary |
Coordinated Choice Plan (HMO)
![Email Prescription and/or Health Benefit details for Coordinated Choice Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.00 |
$360 |
to be determined |
5 |
Specialty Tier |
25% | 25% | P | $5,429.86 |
Browse Plan Formulary |
Coordinated Choice Plan (HMO)
![Email Prescription and/or Health Benefit details for Coordinated Choice Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.00 |
$360 |
to be determined |
5 |
Specialty Tier |
25% | 25% | P | $5,429.86 |
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 |
Dual Coverage (HMO SNP)
![Email Prescription and/or Health Benefit details for Dual Coverage (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.00 |
$360 |
to be determined |
5 |
Specialty Tier |
25% | 25% | None | $5,391.02 |
Browse Plan Formulary |
Dual Coverage (HMO SNP)
![Email Prescription and/or Health Benefit details for Dual Coverage (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.00 |
$360 |
to be determined |
5 |
Specialty Tier |
25% | 25% | None | $5,391.02 |
Browse Plan Formulary |
Harmony - Dual Access (HMO SNP)
![Email Prescription and/or Health Benefit details for Harmony - Dual Access (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.00 |
$360 |
to be determined |
5 |
Specialty Tier |
25% | 25% | None | $5,391.02 |
Browse Plan Formulary |
Harmony - Dual Access (HMO SNP)
![Email Prescription and/or Health Benefit details for Harmony - Dual Access (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.00 |
$360 |
to be determined |
5 |
Specialty Tier |
25% | 25% | None | $5,391.02 |
Browse Plan Formulary |
Health Net Seniority Plus Amber I (HMO SNP)
![Email Prescription and/or Health Benefit details for Health Net Seniority Plus Amber I (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.00 |
$270 |
to be determined |
5 |
Specialty Tier |
27% | 27% | P | $5,503.03 |
Browse Plan Formulary |
Health Net Seniority Plus Amber I (HMO SNP)
![Email Prescription and/or Health Benefit details for Health Net Seniority Plus Amber I (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.00 |
$270 |
to be determined |
5 |
Specialty Tier |
27% | 27% | P | $5,503.03 |
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 |
Health Net Seniority Plus Amber II (HMO SNP)
![Email Prescription and/or Health Benefit details for Health Net Seniority Plus Amber II (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.00 |
$280 |
to be determined |
5 |
Specialty Tier |
26% | 26% | P | $5,499.76 |
Browse Plan Formulary |
Health Net Seniority Plus Amber II (HMO SNP)
![Email Prescription and/or Health Benefit details for Health Net Seniority Plus Amber II (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.00 |
$280 |
to be determined |
5 |
Specialty Tier |
26% | 26% | P | $5,504.22 |
Browse Plan Formulary |
Health Net Seniority Plus Amber II (HMO SNP)
![Email Prescription and/or Health Benefit details for Health Net Seniority Plus Amber II (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.00 |
$280 |
to be determined |
5 |
Specialty Tier |
26% | 26% | P | $5,499.76 |
Browse Plan Formulary |
Health Net Seniority Plus Amber II (HMO SNP)
![Email Prescription and/or Health Benefit details for Health Net Seniority Plus Amber II (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.00 |
$280 |
to be determined |
5 |
Specialty Tier |
26% | 26% | P | $5,504.22 |
Browse Plan Formulary |
Health Net Seniority Plus Sapphire (HMO)
![Email Prescription and/or Health Benefit details for Health Net Seniority Plus Sapphire (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.00 |
$290 |
to be determined |
5 |
Specialty Tier |
26% | 26% | P | $5,499.76 |
Browse Plan Formulary |
Health Net Seniority Plus Sapphire (HMO)
![Email Prescription and/or Health Benefit details for Health Net Seniority Plus Sapphire (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.00 |
$290 |
to be determined |
5 |
Specialty Tier |
26% | 26% | P | $5,504.70 |
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 |
Health Net Seniority Plus Sapphire (HMO)
![Email Prescription and/or Health Benefit details for Health Net Seniority Plus Sapphire (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.00 |
$290 |
to be determined |
5 |
Specialty Tier |
26% | 26% | P | $5,499.76 |
Browse Plan Formulary |
Health Net Seniority Plus Sapphire (HMO)
![Email Prescription and/or Health Benefit details for Health Net Seniority Plus Sapphire (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.00 |
$290 |
to be determined |
5 |
Specialty Tier |
26% | 26% | P | $5,504.70 |
Browse Plan Formulary |
Health Net Seniority Plus Sapphire Premier (HMO)
![Email Prescription and/or Health Benefit details for Health Net Seniority Plus Sapphire Premier (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.00 |
$310 |
to be determined |
5 |
Specialty Tier |
26% | 26% | P | $5,504.22 |
Browse Plan Formulary |
Health Net Seniority Plus Sapphire Premier (HMO)
![Email Prescription and/or Health Benefit details for Health Net Seniority Plus Sapphire Premier (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.00 |
$310 |
to be determined |
5 |
Specialty Tier |
26% | 26% | P | $5,504.22 |
Browse Plan Formulary |
Healthy Heart - Dual Access (HMO SNP)
![Email Prescription and/or Health Benefit details for Healthy Heart - Dual Access (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.00 |
$360 |
to be determined |
5 |
Specialty Tier |
25% | 25% | None | $5,391.02 |
Browse Plan Formulary |
Healthy Heart - Dual Access (HMO SNP)
![Email Prescription and/or Health Benefit details for Healthy Heart - Dual Access (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.00 |
$360 |
to be determined |
5 |
Specialty Tier |
25% | 25% | None | $5,391.02 |
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 |
In Control - Dual Access (HMO SNP)
![Email Prescription and/or Health Benefit details for In Control - Dual Access (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.00 |
$360 |
to be determined |
5 |
Specialty Tier |
25% | 25% | None | $5,391.02 |
Browse Plan Formulary |
In Control - Dual Access (HMO SNP)
![Email Prescription and/or Health Benefit details for In Control - Dual Access (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.00 |
$360 |
to be determined |
5 |
Specialty Tier |
25% | 25% | None | $5,391.02 |
Browse Plan Formulary |
Central Health Advance Plan (HMO SNP)
![Email Prescription and/or Health Benefit details for Central Health Advance Plan (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.10 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | n/a | P Q:2 /30Days | $5,582.87 |
Browse Plan Formulary |
Central Health Advance Plan (HMO SNP)
![Email Prescription and/or Health Benefit details for Central Health Advance Plan (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.10 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | n/a | P Q:2 /30Days | $5,582.87 |
Browse Plan Formulary |
Central Health Medi-Medi Plan (HMO SNP)
![Email Prescription and/or Health Benefit details for Central Health Medi-Medi Plan (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.10 |
$360 |
to be determined |
5 |
Specialty Tier |
25% | n/a | P Q:2 /30Days | $5,582.87 |
Browse Plan Formulary |
Central Health Medi-Medi Plan (HMO SNP)
![Email Prescription and/or Health Benefit details for Central Health Medi-Medi Plan (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.10 |
$360 |
to be determined |
5 |
Specialty Tier |
25% | n/a | P Q:2 /30Days | $5,582.87 |
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 |
Central Health Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Central Health Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.10 |
$360 |
to be determined |
5 |
Specialty Tier |
25% | n/a | P Q:2 /30Days | $5,582.87 |
Browse Plan Formulary |
Central Health Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Central Health Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.10 |
$360 |
to be determined |
5 |
Specialty Tier |
25% | n/a | P Q:2 /30Days | $5,582.87 |
Browse Plan Formulary |
Humana Gold Plus H5619-022 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H5619-022 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | n/a | P Q:1 /28Days | $5,406.92 |
Browse Plan Formulary |
Humana Gold Plus H5619-022 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H5619-022 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.00 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | n/a | P Q:1 /28Days | $5,406.92 |
Browse Plan Formulary |