FLUOXETINE CAPSULES 10MG (100 CT) (100 BOTPL) (NDC: 50111064701)
2017 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 |
$400 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$18.00 | n/a | None | $1.93 |
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 |
$400 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$18.00 | n/a | None | $1.93 |
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 |
$400 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$18.00 | n/a | None | $1.93 |
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 |
$400 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$18.00 | n/a | None | $1.93 |
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 |
$400 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$18.00 | n/a | None | $1.93 |
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 (HMO)
![Email Prescription and/or Health Benefit details for HAP Senior Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$400 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Preferred Generic |
$2.00 | n/a | None | $4.06 |
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 |
$400 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
25% | n/a | None | $6.46 |
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 |
$400 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
25% | n/a | None | $6.36 |
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 |
$400 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
25% | n/a | None | $6.38 |
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 |
$400 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
25% | n/a | None | $6.47 |
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 |
$400 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
25% | n/a | None | $6.41 |
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) |
$18.00 |
$400 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
25% | n/a | None | $6.41 |
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) |
$18.00 |
$400 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
25% | n/a | None | $6.46 |
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) |
$18.00 |
$400 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
25% | n/a | None | $6.36 |
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) |
$18.00 |
$400 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
25% | n/a | None | $6.38 |
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) |
$18.00 |
$400 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
25% | n/a | None | $6.47 |
Browse Plan Formulary |
BCN Advantage HMO HealthySaver (HMO)
![Email Prescription and/or Health Benefit details for BCN Advantage HMO HealthySaver (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$100* |
No additional gap coverage, only the Donut Hole Discount |
2* |
Generic |
$20.00 | n/a | None | $1.93 |
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 HealthySaver (HMO)
![Email Prescription and/or Health Benefit details for BCN Advantage HMO HealthySaver (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$100* |
No additional gap coverage, only the Donut Hole Discount |
2* |
Generic |
$20.00 | n/a | None | $1.93 |
Browse Plan Formulary |
BCN Advantage HMO HealthySaver (HMO)
![Email Prescription and/or Health Benefit details for BCN Advantage HMO HealthySaver (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$100* |
No additional gap coverage, only the Donut Hole Discount |
2* |
Generic |
$20.00 | n/a | None | $1.93 |
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) |
$25.50 |
$400 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Preferred Generic |
20% | 20% | Q:60 /30Days | $2.56 |
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) |
$30.50 |
$400 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | n/a | None | $1.93 |
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) |
$30.50 |
$400 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | n/a | None | $1.93 |
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) |
$30.50 |
$400 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | n/a | None | $1.93 |
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 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) |
$30.50 |
$400 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | n/a | None | $1.93 |
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) |
$30.50 |
$400 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | n/a | None | $1.93 |
Browse Plan Formulary |
HAP Senior Plus Option 1 (HMO-POS)
![Email Prescription and/or Health Benefit details for HAP Senior Plus Option 1 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Preferred Generic |
$6.00 | n/a | None | $4.06 |
Browse Plan Formulary |
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) |
$58.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$15.00 | n/a | None | $1.93 |
Browse Plan Formulary |
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) |
$78.00 |
$75 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Preferred Generic |
$2.00 | n/a | None | $6.60 |
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) |
$86.00 |
$400 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | n/a | None | $1.93 |
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) |
$86.00 |
$400 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | n/a | None | $1.93 |
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) |
$86.00 |
$400 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | n/a | None | $1.93 |
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) |
$86.00 |
$400 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | n/a | None | $1.93 |
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) |
$86.00 |
$400 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | n/a | None | $1.93 |
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) |
$87.00 |
$75* |
No additional gap coverage, only the Donut Hole Discount |
1* |
Preferred Generic |
$2.00 | n/a | None | $6.60 |
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) |
$87.00 |
$75* |
No additional gap coverage, only the Donut Hole Discount |
1* |
Preferred Generic |
$2.00 | n/a | None | $6.64 |
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) |
$87.00 |
$75* |
No additional gap coverage, only the Donut Hole Discount |
1* |
Preferred Generic |
$2.00 | n/a | None | $6.61 |
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) |
$87.00 |
$75* |
No additional gap coverage, only the Donut Hole Discount |
1* |
Preferred Generic |
$2.00 | n/a | None | $6.52 |
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) |
$87.00 |
$75* |
No additional gap coverage, only the Donut Hole Discount |
1* |
Preferred Generic |
$2.00 | n/a | None | $6.60 |
Browse Plan Formulary |
HAP Senior Plus Option 2 (HMO-POS)
![Email Prescription and/or Health Benefit details for HAP Senior Plus Option 2 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$97.00 |
$100* |
No additional gap coverage, only the Donut Hole Discount |
1* |
Preferred Generic |
$2.00 | n/a | None | $4.06 |
Browse Plan Formulary |
HAP Senior Plus Option 1 (PPO)
![Email Prescription and/or Health Benefit details for HAP Senior Plus Option 1 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$124.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Preferred Generic |
$2.00 | n/a | None | $4.06 |
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) |
$139.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$10.00 | n/a | None | $1.93 |
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) |
$139.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$10.00 | n/a | None | $1.93 |
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) |
$139.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$10.00 | n/a | None | $1.93 |
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) |
$139.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$10.00 | n/a | None | $1.93 |
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) |
$139.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$10.00 | n/a | None | $1.93 |
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) |
$160.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Preferred Generic |
$1.00 | n/a | None | $6.60 |
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) |
$174.50 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Preferred Generic |
$1.00 | n/a | None | $6.60 |
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) |
$174.50 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Preferred Generic |
$1.00 | n/a | None | $6.60 |
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) |
$174.50 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Preferred Generic |
$1.00 | n/a | None | $6.64 |
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) |
$174.50 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Preferred Generic |
$1.00 | n/a | None | $6.61 |
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) |
$174.50 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Preferred Generic |
$1.00 | n/a | None | $6.52 |
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) |
$181.00 |
$105 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
45% | n/a | None | $1.93 |
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) |
$181.00 |
$105 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
45% | n/a | None | $1.93 |
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) |
$181.00 |
$105 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
45% | n/a | None | $1.93 |
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) |
$181.00 |
$105 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
45% | n/a | None | $1.93 |
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) |
$181.00 |
$105 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
45% | n/a | None | $1.93 |
Browse Plan Formulary |
HAP Senior Plus Option 2 (PPO)
![Email Prescription and/or Health Benefit details for HAP Senior Plus Option 2 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$208.00 |
$150* |
Yes, but No Gap Coverage for this drug. |
1* |
Preferred Generic |
$4.00 | n/a | None | $4.06 |
Browse Plan Formulary |
HAP Senior Plus Option 3 (HMO-POS)
![Email Prescription and/or Health Benefit details for HAP Senior Plus Option 3 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$218.00 |
$50* |
Yes, but No Gap Coverage for this drug. |
1* |
Preferred Generic |
$4.00 | n/a | None | $4.06 |
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) |
$264.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
45% | n/a | None | $1.93 |
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) |
$264.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
45% | n/a | None | $1.93 |
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) |
$264.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
45% | n/a | None | $1.93 |
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) |
$264.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
45% | n/a | None | $1.93 |
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) |
$264.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
45% | n/a | None | $1.93 |
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) |
$280.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$10.00 | n/a | None | $1.93 |
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) |
$280.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$10.00 | n/a | None | $1.93 |
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 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) |
$280.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$10.00 | n/a | None | $1.93 |
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) |
$280.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$10.00 | n/a | None | $1.93 |
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) |
$280.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$10.00 | n/a | None | $1.93 |
Browse Plan Formulary |