Humana Gold Choice H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Atchison |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Barber |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Barton |
$75.00 |
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 H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Brown |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Chase |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Chautauqua |
$75.00 |
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 H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Cheyenne |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Clark |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Clay |
$75.00 |
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 H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Cloud |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Coffey |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Comanche |
$75.00 |
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 H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Decatur |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Doniphan |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Edwards |
$75.00 |
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 H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Elk |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Ellis |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Ellsworth |
$75.00 |
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 H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Finney |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Ford |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Geary |
$75.00 |
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 H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Gove |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Graham |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Grant |
$75.00 |
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 H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Gray |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Greeley |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Greenwood |
$75.00 |
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 H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Hamilton |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Harper |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Haskell |
$75.00 |
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 H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Hodgeman |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Jackson |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Jewell |
$75.00 |
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 H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Kearny |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Kiowa |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Lane |
$75.00 |
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 H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Lincoln |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Logan |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Lyon |
$75.00 |
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 H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
McPherson |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Marshall |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Meade |
$75.00 |
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 H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Mitchell |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Morton |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Nemaha |
$75.00 |
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 H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Neosho |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Ness |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Norton |
$75.00 |
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 H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Osborne |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Pawnee |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Phillips |
$75.00 |
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 H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Pratt |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Rawlins |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Republic |
$75.00 |
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 H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Rice |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Riley |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Rooks |
$75.00 |
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 H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Rush |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Russell |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Saline |
$75.00 |
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 H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Scott |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Seward |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Sheridan |
$75.00 |
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 H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Sherman |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Smith |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Stafford |
$75.00 |
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 H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Stanton |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Stevens |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Thomas |
$75.00 |
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 H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Trego |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Wallace |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Washington |
$75.00 |
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 H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Wichita |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Wilson |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in KS - H2944-197-0
Benefit Details
|
Woodson |
$75.00 |
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 H2944-197 (PFFS) in MO - H2944-197-0
Benefit Details
|
Adair |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in MO - H2944-197-0
Benefit Details
|
Atchison |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in MO - H2944-197-0
Benefit Details
|
Bollinger |
$75.00 |
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 H2944-197 (PFFS) in MO - H2944-197-0
Benefit Details
|
Butler |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in MO - H2944-197-0
Benefit Details
|
Camden |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in MO - H2944-197-0
Benefit Details
|
Cape Girardeau |
$75.00 |
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 H2944-197 (PFFS) in MO - H2944-197-0
Benefit Details
|
Carter |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in MO - H2944-197-0
Benefit Details
|
Chariton |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
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Humana Gold Choice H2944-197 (PFFS) in MO - H2944-197-0
Benefit Details
|
Clark |
$75.00 |
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 H2944-197 (PFFS) in MO - H2944-197-0
Benefit Details
|
DeKalb |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in MO - H2944-197-0
Benefit Details
|
Dent |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in MO - H2944-197-0
Benefit Details
|
Dunklin |
$75.00 |
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 H2944-197 (PFFS) in MO - H2944-197-0
Benefit Details
|
Gentry |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in MO - H2944-197-0
Benefit Details
|
Grundy |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in MO - H2944-197-0
Benefit Details
|
Holt |
$75.00 |
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 H2944-197 (PFFS) in MO - H2944-197-0
Benefit Details
|
Iron |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in MO - H2944-197-0
Benefit Details
|
Lewis |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in MO - H2944-197-0
Benefit Details
|
Linn |
$75.00 |
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 H2944-197 (PFFS) in MO - H2944-197-0
Benefit Details
|
Macon |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in MO - H2944-197-0
Benefit Details
|
Madison |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in MO - H2944-197-0
Benefit Details
|
Marion |
$75.00 |
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 H2944-197 (PFFS) in MO - H2944-197-0
Benefit Details
|
Mercer |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in MO - H2944-197-0
Benefit Details
|
Mississippi |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in MO - H2944-197-0
Benefit Details
|
New Madrid |
$75.00 |
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 H2944-197 (PFFS) in MO - H2944-197-0
Benefit Details
|
Nodaway |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in MO - H2944-197-0
Benefit Details
|
Putnam |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in MO - H2944-197-0
Benefit Details
|
Ralls |
$75.00 |
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 H2944-197 (PFFS) in MO - H2944-197-0
Benefit Details
|
Ripley |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in MO - H2944-197-0
Benefit Details
|
Schuyler |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in MO - H2944-197-0
Benefit Details
|
Scotland |
$75.00 |
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 H2944-197 (PFFS) in MO - H2944-197-0
Benefit Details
|
Scott |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in MO - H2944-197-0
Benefit Details
|
Stoddard |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in MO - H2944-197-0
Benefit Details
|
Sullivan |
$75.00 |
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 H2944-197 (PFFS) in MO - H2944-197-0
Benefit Details
|
Wayne |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in MO - H2944-197-0
Benefit Details
|
Worth |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in OK - H2944-197-0
Benefit Details
|
Atoka |
$75.00 |
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 H2944-197 (PFFS) in OK - H2944-197-0
Benefit Details
|
Beckham |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in OK - H2944-197-0
Benefit Details
|
Bryan |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in OK - H2944-197-0
Benefit Details
|
Choctaw |
$75.00 |
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 H2944-197 (PFFS) in OK - H2944-197-0
Benefit Details
|
Cimarron |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in OK - H2944-197-0
Benefit Details
|
Coal |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in OK - H2944-197-0
Benefit Details
|
Harper |
$75.00 |
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 H2944-197 (PFFS) in OK - H2944-197-0
Benefit Details
|
Jackson |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in OK - H2944-197-0
Benefit Details
|
Johnston |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in OK - H2944-197-0
Benefit Details
|
Latimer |
$75.00 |
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 H2944-197 (PFFS) in OK - H2944-197-0
Benefit Details
|
Love |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in OK - H2944-197-0
Benefit Details
|
McCurtain |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in OK - H2944-197-0
Benefit Details
|
Roger Mills |
$75.00 |
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 H2944-197 (PFFS) in OK - H2944-197-0
Benefit Details
|
Washita |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H2944-197 (PFFS) in OK - H2944-197-0
Benefit Details
|
Woodward |
$75.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|