Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Arkansas |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Ashley |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Baxter |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Benton |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Carroll |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
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|
|
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Cleburne |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Conway |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Craighead |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Crawford |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Crittenden |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Cross |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Dallas |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Faulkner |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Franklin |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Fulton |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Garland |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Greene |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Hot Spring |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Independence |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Jackson |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Jefferson |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Johnson |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Lawrence |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Lee |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Logan |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Marion |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Montgomery |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Pope |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Prairie |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Pulaski |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Randolph |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Saline |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Scott |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Sebastian |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Sharp |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Stone |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Union |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Van Buren |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Washington |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in CO - H8145-120-0
Benefit Details
|
Adams |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in CO - H8145-120-0
Benefit Details
|
Alamosa |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in CO - H8145-120-0
Benefit Details
|
Arapahoe |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in CO - H8145-120-0
Benefit Details
|
Boulder |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in CO - H8145-120-0
Benefit Details
|
Broomfield |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in CO - H8145-120-0
Benefit Details
|
Chaffee |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in CO - H8145-120-0
Benefit Details
|
Clear Creek |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in CO - H8145-120-0
Benefit Details
|
Costilla |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in CO - H8145-120-0
Benefit Details
|
Crowley |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in CO - H8145-120-0
Benefit Details
|
Custer |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in CO - H8145-120-0
Benefit Details
|
Delta |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in CO - H8145-120-0
Benefit Details
|
Denver |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in CO - H8145-120-0
Benefit Details
|
Douglas |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in CO - H8145-120-0
Benefit Details
|
Elbert |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in CO - H8145-120-0
Benefit Details
|
El Paso |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in CO - H8145-120-0
Benefit Details
|
Fremont |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in CO - H8145-120-0
Benefit Details
|
Gilpin |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in CO - H8145-120-0
Benefit Details
|
Grand |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in CO - H8145-120-0
Benefit Details
|
Huerfano |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in CO - H8145-120-0
Benefit Details
|
Jefferson |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in CO - H8145-120-0
Benefit Details
|
Larimer |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in CO - H8145-120-0
Benefit Details
|
Mesa |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in CO - H8145-120-0
Benefit Details
|
Montrose |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in CO - H8145-120-0
Benefit Details
|
Morgan |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in CO - H8145-120-0
Benefit Details
|
Otero |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in CO - H8145-120-0
Benefit Details
|
Park |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in CO - H8145-120-0
Benefit Details
|
Pueblo |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in CO - H8145-120-0
Benefit Details
|
Weld |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in KS - H8145-120-0
Benefit Details
|
Anderson |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in KS - H8145-120-0
Benefit Details
|
Bourbon |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in KS - H8145-120-0
Benefit Details
|
Butler |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in KS - H8145-120-0
Benefit Details
|
Cherokee |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in KS - H8145-120-0
Benefit Details
|
Crawford |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in KS - H8145-120-0
Benefit Details
|
Harvey |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in KS - H8145-120-0
Benefit Details
|
Johnson |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in KS - H8145-120-0
Benefit Details
|
Labette |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in KS - H8145-120-0
Benefit Details
|
Leavenworth |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in KS - H8145-120-0
Benefit Details
|
Sedgwick |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in KS - H8145-120-0
Benefit Details
|
Wyandotte |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Barry |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Barton |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Benton |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Boone |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Callaway |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Carroll |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Cass |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Cedar |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Christian |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Clay |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Cole |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Crawford |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Dade |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Dallas |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Douglas |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Gasconade |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Greene |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Henry |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Hickory |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Jackson |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Jasper |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Jefferson |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Laclede |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Lawrence |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
McDonald |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Miller |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Montgomery |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Newton |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Ozark |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Pemiscot |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Perry |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Phelps |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Pike |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Platte |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Polk |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Pulaski |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Reynolds |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
St. Charles |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
St. Clair |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Ste. Genevieve |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
St. Louis |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Stone |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Taney |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Vernon |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Washington |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Wright |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
St. Louis City |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
Adair |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
Caddo |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
Canadian |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
Cleveland |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
Craig |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
Delaware |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
Garvin |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
Grady |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
Haskell |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
Kingfisher |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
Logan |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
McClain |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
McIntosh |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
Marshall |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
Mayes |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
Murray |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
Muskogee |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
Oklahoma |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
Okmulgee |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
Ottawa |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
Pottawatomie |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
Seminole |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
Sequoyah |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
Tulsa |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
Wagoner |
$34.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|