FULPHILA 6 MG/0.6 ML SYRINGE (ml ) (NDC: 67457083306)
2019 Medicare Prescription Drug Plan (MAPD) Information
Click here for the Chart Legend |
See your cost using a drug discount card: Compare prices at pharmacies near you |
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 |
Geisinger Gold Classic Essential Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic Essential Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,121.65 |
Browse Plan Formulary |
Geisinger Gold Classic Essential Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic Essential Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,121.65 |
Browse Plan Formulary |
Geisinger Gold Classic Essential Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic Essential Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,121.65 |
Browse Plan Formulary |
Geisinger Gold Classic Essential Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic Essential Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,121.65 |
Browse Plan Formulary |
Geisinger Gold Classic Essential Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic Essential Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,121.65 |
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 |
Geisinger Gold Classic Essential Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic Essential Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,121.65 |
Browse Plan Formulary |
Geisinger Gold Classic Essential Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic Essential Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,121.65 |
Browse Plan Formulary |
Geisinger Gold Classic Essential Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic Essential Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,121.65 |
Browse Plan Formulary |
Geisinger Gold Classic Essential Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic Essential Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,121.65 |
Browse Plan Formulary |
Geisinger Gold Preferred Complete Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Complete Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,121.65 |
Browse Plan Formulary |
Geisinger Gold Preferred Complete Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Complete Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,121.65 |
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 |
Geisinger Gold Preferred Complete Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Complete Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,121.65 |
Browse Plan Formulary |
Geisinger Gold Preferred Complete Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Complete Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,121.65 |
Browse Plan Formulary |
Geisinger Gold Preferred Complete Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Complete Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,121.65 |
Browse Plan Formulary |
Geisinger Gold Preferred Complete Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Complete Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,121.65 |
Browse Plan Formulary |
Geisinger Gold Preferred Complete Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Complete Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,121.65 |
Browse Plan Formulary |
Geisinger Gold Preferred Complete Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Complete Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,121.65 |
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 |
Geisinger Gold Preferred Complete Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Complete Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,121.65 |
Browse Plan Formulary |
Humana Gold Plus H6622-037 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H6622-037 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
33% | n/a | P Q:1 /28Days | $4,254.32 |
Browse Plan Formulary |
Humana Gold Plus H6622-039 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H6622-039 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$350 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
26% | n/a | P Q:1 /28Days | $4,254.32 |
Browse Plan Formulary |
HumanaChoice H5525-038 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-038 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
33% | n/a | P Q:1 /28Days | $4,254.32 |
Browse Plan Formulary |
Keystone 65 Basic Rx (HMO)
![Email Prescription and/or Health Benefit details for Keystone 65 Basic Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
33% | 33% | Q:2 /28Days | $4,291.90 |
Browse Plan Formulary |
Keystone 65 Focus Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Keystone 65 Focus Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
33% | 33% | Q:2 /28Days | $4,291.90 |
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 |
HumanaChoice R0923-002 (Regional PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice R0923-002 (Regional PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.90 |
$0 |
to be determined |
5 |
Specialty Tier |
33% | n/a | P Q:1 /28Days | $4,254.32 |
Browse Plan Formulary |
Humana Gold Plus SNP-DE H6622-038 (HMO SNP)
![Email Prescription and/or Health Benefit details for Humana Gold Plus SNP-DE H6622-038 (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.40 |
$300 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
27% | n/a | P Q:1 /28Days | $4,254.32 |
Browse Plan Formulary |
Gateway Health Medicare Assured Diamond (HMO SNP)
![Email Prescription and/or Health Benefit details for Gateway Health Medicare Assured Diamond (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.00 |
$415 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
25% | n/a | P | $4,444.47 |
Browse Plan Formulary |
Gateway Health Medicare Assured Ruby (HMO SNP)
![Email Prescription and/or Health Benefit details for Gateway Health Medicare Assured Ruby (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.00 |
$415 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
25% | n/a | P | $4,444.47 |
Browse Plan Formulary |
Health Partners Medicare Special (HMO SNP)
![Email Prescription and/or Health Benefit details for Health Partners Medicare Special (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.00 |
$415 |
No additional gap coverage, only the Donut Hole Discount |
1 |
All Formulary Drugs |
15% | 15% | Q:2 /28Days | $4,146.72 |
Browse Plan Formulary |
Sunrise Advantage Plan I-SNP (HMO SNP)
![Email Prescription and/or Health Benefit details for Sunrise Advantage Plan I-SNP (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
33% | n/a | None | $4,299.69 |
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 |
Geisinger Gold Classic Complete Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic Complete Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,096.28 |
Browse Plan Formulary |
Geisinger Gold Classic Complete Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic Complete Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,096.28 |
Browse Plan Formulary |
Geisinger Gold Classic Complete Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic Complete Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,096.28 |
Browse Plan Formulary |
Geisinger Gold Classic Complete Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic Complete Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,096.28 |
Browse Plan Formulary |
Geisinger Gold Classic Complete Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic Complete Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,096.28 |
Browse Plan Formulary |
Geisinger Gold Classic Complete Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic Complete Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,096.28 |
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 |
Geisinger Gold Classic Complete Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic Complete Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,096.28 |
Browse Plan Formulary |
Geisinger Gold Classic Complete Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic Complete Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,096.28 |
Browse Plan Formulary |
Geisinger Gold Classic Complete Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic Complete Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,096.28 |
Browse Plan Formulary |
Sunrise Advantage Plan (HMO)
![Email Prescription and/or Health Benefit details for Sunrise Advantage Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
33% | n/a | None | $4,301.06 |
Browse Plan Formulary |
Geisinger Gold Preferred Enhanced Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Enhanced Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$45.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,121.65 |
Browse Plan Formulary |
Geisinger Gold Preferred Enhanced Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Enhanced Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$45.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,121.65 |
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 |
Geisinger Gold Preferred Enhanced Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Enhanced Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$45.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,121.65 |
Browse Plan Formulary |
Geisinger Gold Preferred Enhanced Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Enhanced Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$45.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,121.65 |
Browse Plan Formulary |
Geisinger Gold Preferred Enhanced Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Enhanced Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$45.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,121.65 |
Browse Plan Formulary |
Geisinger Gold Preferred Enhanced Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Enhanced Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$45.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,121.65 |
Browse Plan Formulary |
Geisinger Gold Preferred Enhanced Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Enhanced Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$45.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,121.65 |
Browse Plan Formulary |
Geisinger Gold Preferred Enhanced Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Enhanced Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$45.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,121.65 |
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 |
Geisinger Gold Preferred Enhanced Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Enhanced Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$45.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,121.65 |
Browse Plan Formulary |
HumanaChoice H5525-005 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-005 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$45.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
33% | n/a | P Q:1 /28Days | $4,254.32 |
Browse Plan Formulary |
Sunrise Advantage Plan C-SNP (HMO SNP)
![Email Prescription and/or Health Benefit details for Sunrise Advantage Plan C-SNP (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
33% | n/a | None | $4,298.36 |
Browse Plan Formulary |
Keystone 65 Select Rx (HMO)
![Email Prescription and/or Health Benefit details for Keystone 65 Select Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$68.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
33% | 33% | Q:2 /28Days | $4,292.22 |
Browse Plan Formulary |
Health Partners Medicare Prime (HMO)
![Email Prescription and/or Health Benefit details for Health Partners Medicare Prime (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$71.00 |
$350 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
26% | n/a | Q:2 /28Days | $4,146.56 |
Browse Plan Formulary |
Geisinger Gold Preferred Advantage Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Advantage Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$87.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,121.65 |
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 |
Geisinger Gold Preferred Advantage Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Advantage Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$87.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,121.65 |
Browse Plan Formulary |
Geisinger Gold Preferred Advantage Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Advantage Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$87.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,121.65 |
Browse Plan Formulary |
Geisinger Gold Preferred Advantage Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Advantage Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$87.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,121.65 |
Browse Plan Formulary |
Geisinger Gold Preferred Advantage Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Advantage Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$87.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,121.65 |
Browse Plan Formulary |
Geisinger Gold Preferred Advantage Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Advantage Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$87.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,121.65 |
Browse Plan Formulary |
Geisinger Gold Preferred Advantage Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Advantage Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$87.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,121.65 |
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 |
Geisinger Gold Preferred Advantage Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Advantage Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$87.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,121.65 |
Browse Plan Formulary |
Geisinger Gold Preferred Advantage Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Advantage Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$87.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,121.65 |
Browse Plan Formulary |
Geisinger Gold Classic Advantage Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic Advantage Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$135.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,096.28 |
Browse Plan Formulary |
Geisinger Gold Classic Advantage Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic Advantage Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$135.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,096.28 |
Browse Plan Formulary |
Geisinger Gold Classic Advantage Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic Advantage Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$135.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,096.28 |
Browse Plan Formulary |
Geisinger Gold Classic Advantage Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic Advantage Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$135.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,096.28 |
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 |
Geisinger Gold Classic Advantage Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic Advantage Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$135.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,096.28 |
Browse Plan Formulary |
Geisinger Gold Classic Advantage Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic Advantage Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$135.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,096.28 |
Browse Plan Formulary |
Geisinger Gold Classic Advantage Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic Advantage Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$135.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,096.28 |
Browse Plan Formulary |
Geisinger Gold Classic Advantage Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic Advantage Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$135.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,096.28 |
Browse Plan Formulary |
Geisinger Gold Classic Advantage Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic Advantage Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$135.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
5 |
Specialty Tier |
33% | n/a | P | $4,096.28 |
Browse Plan Formulary |
HumanaChoice H5216-122 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-122 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$147.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
33% | n/a | P Q:1 /28Days | $4,254.32 |
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 |
Sunrise Advantage Plan Gold (HMO SNP)
![Email Prescription and/or Health Benefit details for Sunrise Advantage Plan Gold (HMO SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$175.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
33% | n/a | None | $4,301.06 |
Browse Plan Formulary |
Keystone 65 Preferred Rx (HMO)
![Email Prescription and/or Health Benefit details for Keystone 65 Preferred Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$229.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
33% | 33% | Q:2 /28Days | $4,292.22 |
Browse Plan Formulary |
Personal Choice 65 Rx (PPO)
![Email Prescription and/or Health Benefit details for Personal Choice 65 Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$289.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
5 |
Specialty Tier |
33% | 33% | Q:2 /28Days | $4,292.22 |
Browse Plan Formulary |