UnitedHealthcare MedicareDirect Essential (PFFS) in AZ - H5435-001-0
Benefit Details
|
Navajo |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in GA - H5435-001-0
Benefit Details
|
Calhoun |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in GA - H5435-001-0
Benefit Details
|
Clay |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in GA - H5435-001-0
Benefit Details
|
Crisp |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in GA - H5435-001-0
Benefit Details
|
Decatur |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in GA - H5435-001-0
Benefit Details
|
Grady |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in GA - H5435-001-0
Benefit Details
|
Lanier |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in GA - H5435-001-0
Benefit Details
|
Quitman |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in GA - H5435-001-0
Benefit Details
|
Thomas |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in GA - H5435-001-0
Benefit Details
|
Tift |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in GA - H5435-001-0
Benefit Details
|
Turner |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in KS - H5435-001-0
Benefit Details
|
Anderson |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in KS - H5435-001-0
Benefit Details
|
Chase |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in KS - H5435-001-0
Benefit Details
|
Cheyenne |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in KS - H5435-001-0
Benefit Details
|
Clay |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in KS - H5435-001-0
Benefit Details
|
Cloud |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in KS - H5435-001-0
Benefit Details
|
Decatur |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in KS - H5435-001-0
Benefit Details
|
Ellis |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in KS - H5435-001-0
Benefit Details
|
Geary |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in KS - H5435-001-0
Benefit Details
|
Graham |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in KS - H5435-001-0
Benefit Details
|
Lane |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in KS - H5435-001-0
Benefit Details
|
Logan |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in KS - H5435-001-0
Benefit Details
|
McPherson |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in KS - H5435-001-0
Benefit Details
|
Marshall |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in KS - H5435-001-0
Benefit Details
|
Nemaha |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in KS - H5435-001-0
Benefit Details
|
Neosho |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in KS - H5435-001-0
Benefit Details
|
Phillips |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in KS - H5435-001-0
Benefit Details
|
Rawlins |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in KS - H5435-001-0
Benefit Details
|
Republic |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in KS - H5435-001-0
Benefit Details
|
Riley |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in KS - H5435-001-0
Benefit Details
|
Rooks |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in KS - H5435-001-0
Benefit Details
|
Saline |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in KS - H5435-001-0
Benefit Details
|
Scott |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in KS - H5435-001-0
Benefit Details
|
Sheridan |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in KS - H5435-001-0
Benefit Details
|
Thomas |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in KS - H5435-001-0
Benefit Details
|
Washington |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in KS - H5435-001-0
Benefit Details
|
Wilson |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in KY - H5435-001-0
Benefit Details
|
Calloway |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in KY - H5435-001-0
Benefit Details
|
Christian |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in KY - H5435-001-0
Benefit Details
|
Cumberland |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in KY - H5435-001-0
Benefit Details
|
Marshall |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in KY - H5435-001-0
Benefit Details
|
Monroe |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in MO - H5435-001-0
Benefit Details
|
Adair |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in MO - H5435-001-0
Benefit Details
|
Bollinger |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in MO - H5435-001-0
Benefit Details
|
Cape Girardeau |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in MO - H5435-001-0
Benefit Details
|
Clark |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in MO - H5435-001-0
Benefit Details
|
Daviess |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in MO - H5435-001-0
Benefit Details
|
Grundy |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in MO - H5435-001-0
Benefit Details
|
Iron |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in MO - H5435-001-0
Benefit Details
|
Lewis |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in MO - H5435-001-0
Benefit Details
|
Madison |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in MO - H5435-001-0
Benefit Details
|
Marion |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in MO - H5435-001-0
Benefit Details
|
Mercer |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in MO - H5435-001-0
Benefit Details
|
New Madrid |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in MO - H5435-001-0
Benefit Details
|
Putnam |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in MO - H5435-001-0
Benefit Details
|
Ralls |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in MO - H5435-001-0
Benefit Details
|
Schuyler |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in MO - H5435-001-0
Benefit Details
|
Scotland |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in MO - H5435-001-0
Benefit Details
|
Scott |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in MO - H5435-001-0
Benefit Details
|
Shannon |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in MO - H5435-001-0
Benefit Details
|
Stoddard |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in MO - H5435-001-0
Benefit Details
|
Sullivan |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in MO - H5435-001-0
Benefit Details
|
Wayne |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in MT - H5435-001-0
Benefit Details
|
Carter |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in MT - H5435-001-0
Benefit Details
|
Daniels |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in MT - H5435-001-0
Benefit Details
|
Dawson |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in MT - H5435-001-0
Benefit Details
|
Fallon |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in MT - H5435-001-0
Benefit Details
|
Garfield |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in MT - H5435-001-0
Benefit Details
|
Petroleum |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in MT - H5435-001-0
Benefit Details
|
Phillips |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in MT - H5435-001-0
Benefit Details
|
Powder River |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in MT - H5435-001-0
Benefit Details
|
Prairie |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in MT - H5435-001-0
Benefit Details
|
Roosevelt |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in MT - H5435-001-0
Benefit Details
|
Sheridan |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in MT - H5435-001-0
Benefit Details
|
Valley |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in NE - H5435-001-0
Benefit Details
|
Arthur |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in NE - H5435-001-0
Benefit Details
|
Banner |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in NE - H5435-001-0
Benefit Details
|
Blaine |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in NE - H5435-001-0
Benefit Details
|
Boone |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in NE - H5435-001-0
Benefit Details
|
Box Butte |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in NE - H5435-001-0
Benefit Details
|
Buffalo |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in NE - H5435-001-0
Benefit Details
|
Cedar |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in NE - H5435-001-0
Benefit Details
|
Cheyenne |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in NE - H5435-001-0
Benefit Details
|
Dakota |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in NE - H5435-001-0
Benefit Details
|
Dawes |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in NE - H5435-001-0
Benefit Details
|
Dawson |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in NE - H5435-001-0
Benefit Details
|
Dixon |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in NE - H5435-001-0
Benefit Details
|
Gosper |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in NE - H5435-001-0
Benefit Details
|
Hall |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in NE - H5435-001-0
Benefit Details
|
Hamilton |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in NE - H5435-001-0
Benefit Details
|
Hooker |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in NE - H5435-001-0
Benefit Details
|
Kearney |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in NE - H5435-001-0
Benefit Details
|
Keith |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in NE - H5435-001-0
Benefit Details
|
Keya Paha |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in NE - H5435-001-0
Benefit Details
|
Knox |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in NE - H5435-001-0
Benefit Details
|
Logan |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in NE - H5435-001-0
Benefit Details
|
Loup |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in NE - H5435-001-0
Benefit Details
|
McPherson |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in NE - H5435-001-0
Benefit Details
|
Madison |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in NE - H5435-001-0
Benefit Details
|
Merrick |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in NE - H5435-001-0
Benefit Details
|
Morrill |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in NE - H5435-001-0
Benefit Details
|
Nance |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in NE - H5435-001-0
Benefit Details
|
Perkins |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in NE - H5435-001-0
Benefit Details
|
Platte |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in NE - H5435-001-0
Benefit Details
|
Scotts Bluff |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in NE - H5435-001-0
Benefit Details
|
Sheridan |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in NE - H5435-001-0
Benefit Details
|
Sherman |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in NE - H5435-001-0
Benefit Details
|
Stanton |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in NE - H5435-001-0
Benefit Details
|
Thomas |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in NE - H5435-001-0
Benefit Details
|
Wheeler |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in NH - H5435-001-0
Benefit Details
|
Belknap |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in OK - H5435-001-0
Benefit Details
|
Latimer |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in TX - H5435-001-0
Benefit Details
|
Brewster |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in TX - H5435-001-0
Benefit Details
|
Brown |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in TX - H5435-001-0
Benefit Details
|
Calhoun |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in TX - H5435-001-0
Benefit Details
|
Comanche |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in TX - H5435-001-0
Benefit Details
|
Crane |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in TX - H5435-001-0
Benefit Details
|
Culberson |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in TX - H5435-001-0
Benefit Details
|
DeWitt |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in TX - H5435-001-0
Benefit Details
|
Duval |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in TX - H5435-001-0
Benefit Details
|
Eastland |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in TX - H5435-001-0
Benefit Details
|
Goliad |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in TX - H5435-001-0
Benefit Details
|
Gonzales |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in TX - H5435-001-0
Benefit Details
|
Jack |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in TX - H5435-001-0
Benefit Details
|
Jackson |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in TX - H5435-001-0
Benefit Details
|
Karnes |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in TX - H5435-001-0
Benefit Details
|
Kerr |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in TX - H5435-001-0
Benefit Details
|
La Salle |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in TX - H5435-001-0
Benefit Details
|
Live Oak |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in TX - H5435-001-0
Benefit Details
|
Loving |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in TX - H5435-001-0
Benefit Details
|
McMullen |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in TX - H5435-001-0
Benefit Details
|
Pecos |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in TX - H5435-001-0
Benefit Details
|
Presidio |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in TX - H5435-001-0
Benefit Details
|
Reeves |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in TX - H5435-001-0
Benefit Details
|
Refugio |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in TX - H5435-001-0
Benefit Details
|
Terrell |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in TX - H5435-001-0
Benefit Details
|
Uvalde |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in TX - H5435-001-0
Benefit Details
|
Ward |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in TX - H5435-001-0
Benefit Details
|
Winkler |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in VA - H5435-001-0
Benefit Details
|
Augusta |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in VA - H5435-001-0
Benefit Details
|
Brunswick |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in VA - H5435-001-0
Benefit Details
|
Carroll |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in VA - H5435-001-0
Benefit Details
|
Greensville |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in VA - H5435-001-0
Benefit Details
|
Mecklenburg |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in VA - H5435-001-0
Benefit Details
|
Patrick |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in VA - H5435-001-0
Benefit Details
|
Rockingham |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in VA - H5435-001-0
Benefit Details
|
Emporia City |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in VA - H5435-001-0
Benefit Details
|
Harrisonburg City |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in VA - H5435-001-0
Benefit Details
|
Staunton City |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in VA - H5435-001-0
Benefit Details
|
Waynesboro City |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in VT - H5435-001-0
Benefit Details
|
Caledonia |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in VT - H5435-001-0
Benefit Details
|
Essex |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in VT - H5435-001-0
Benefit Details
|
Franklin |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in VT - H5435-001-0
Benefit Details
|
Grand Isle |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in VT - H5435-001-0
Benefit Details
|
Windham |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in VT - H5435-001-0
Benefit Details
|
Windsor |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in WY - H5435-001-0
Benefit Details
|
Albany |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in WY - H5435-001-0
Benefit Details
|
Crook |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in WY - H5435-001-0
Benefit Details
|
Fremont |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in WY - H5435-001-0
Benefit Details
|
Natrona |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in WY - H5435-001-0
Benefit Details
|
Sheridan |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare MedicareDirect Essential (PFFS) in WY - H5435-001-0
Benefit Details
|
Teton |
$40.00 |
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 |
UnitedHealthcare MedicareDirect Essential (PFFS) in WY - H5435-001-0
Benefit Details
|
Weston |
$40.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|