HUMIRA 40 MG/0.4 ML PEN IJ KIT (2 units ) (NDC: 00074055402)
2020 Medicare Prescription Drug Plan (MAPD) Information
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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 |
Aetna Medicare Premier (HMO)
|
$0.00 |
$0 |
No |
5 |
Tier 5 |
33% | n/a | P Q:6 /28Days | $5,608.68 |
Browse Plan Formulary |
Aetna Medicare Value (PPO)
|
$0.00 |
$150 |
No |
5 |
Tier 5 |
30% | n/a | P Q:6 /28Days | $5,605.68 |
Browse Plan Formulary |
Align Connect (HMO C-SNP)
|
$0.00 |
$435 |
No |
5 |
Tier 5 |
25% | n/a | P | $5,564.54 |
Browse Plan Formulary |
BCN Advantage HMO HealthyValue (HMO)
|
$0.00 |
$250 |
No |
5 |
Tier 5 |
28% | n/a | P Q:3 /28Days | $5,288.02 |
Browse Plan Formulary |
BCN Advantage HMO HealthyValue (HMO)
|
$0.00 |
$250 |
No |
5 |
Tier 5 |
28% | n/a | P Q:3 /28Days | $5,375.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
BCN Advantage HMO HealthyValue (HMO)
|
$0.00 |
$250 |
No |
5 |
Tier 5 |
28% | n/a | P Q:3 /28Days | $5,357.22 |
Browse Plan Formulary |
BCN Advantage HMO-POS Basic (HMO-POS)
|
$0.00 |
$200 |
No |
5 |
Tier 5 |
29% | n/a | P Q:3 /28Days | $5,309.68 |
Browse Plan Formulary |
BCN Advantage HMO-POS Basic (HMO-POS)
|
$0.00 |
$200 |
No |
5 |
Tier 5 |
29% | n/a | P Q:3 /28Days | $5,411.16 |
Browse Plan Formulary |
BCN Advantage HMO-POS Basic (HMO-POS)
|
$0.00 |
$200 |
No |
5 |
Tier 5 |
29% | n/a | P Q:3 /28Days | $5,426.78 |
Browse Plan Formulary |
BCN Advantage HMO-POS Basic (HMO-POS)
|
$0.00 |
$200 |
No |
5 |
Tier 5 |
29% | n/a | P Q:3 /28Days | $5,391.38 |
Browse Plan Formulary |
BCN Advantage HMO-POS Basic (HMO-POS)
|
$0.00 |
$200 |
No |
5 |
Tier 5 |
29% | n/a | P Q:3 /28Days | $5,315.34 |
Browse Plan Formulary |
|
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HAP Primary Choice Medicare (HMO)
|
$0.00 |
$0 |
No |
5 |
Tier 5 |
33% | n/a | P | $5,413.98 |
Browse Plan Formulary |
HAP Senior Plus (HMO)
|
$0.00 |
$0 |
No |
5 |
Tier 5 |
33% | n/a | P | $5,464.94 |
Browse Plan Formulary |
HAP Senior Plus Option 1 (PPO)
|
$0.00 |
$0 |
No |
5 |
Tier 5 |
33% | n/a | P | $5,464.94 |
Browse Plan Formulary |
Humana Gold Plus H8908-004 (HMO)
|
$0.00 |
$100 |
No |
5 |
Tier 5 |
31% | n/a | P Q:6 /28Days | $5,834.82 |
Browse Plan Formulary |
PriorityMedicare Edge (PPO)
|
$0.00 |
$75 |
No |
5 |
Tier 5 |
31% | n/a | P Q:2 /28Days | $5,467.16 |
Browse Plan Formulary |
PriorityMedicare Key (HMO-POS)
|
$0.00 |
$100 |
No |
5 |
Tier 5 |
31% | n/a | P Q:2 /28Days | $5,442.08 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
PriorityMedicare Key (HMO-POS)
|
$0.00 |
$100 |
No |
5 |
Tier 5 |
31% | n/a | P Q:2 /28Days | $5,467.16 |
Browse Plan Formulary |
PriorityMedicare Key (HMO-POS)
|
$0.00 |
$100 |
No |
5 |
Tier 5 |
31% | n/a | P Q:2 /28Days | $5,415.40 |
Browse Plan Formulary |
PriorityMedicare Key (HMO-POS)
|
$0.00 |
$100 |
No |
5 |
Tier 5 |
31% | n/a | P Q:2 /28Days | $5,540.80 |
Browse Plan Formulary |
PriorityMedicare Key (HMO-POS)
|
$0.00 |
$100 |
No |
5 |
Tier 5 |
31% | n/a | P Q:2 /28Days | $5,405.20 |
Browse Plan Formulary |
WellCare Essential (HMO-POS)
|
$0.00 |
$0 |
No |
5 |
Tier 5 |
33% | n/a | P Q:6 /28Days | n/a |
Browse Plan Formulary |
Medicare Plus Blue PPO Essential (PPO)
|
$9.00 |
$200 |
No |
5 |
Tier 5 |
29% | n/a | P Q:3 /28Days | $5,315.34 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue PPO Essential (PPO)
|
$9.00 |
$200 |
No |
5 |
Tier 5 |
29% | n/a | P Q:3 /28Days | $5,307.14 |
Browse Plan Formulary |
Medicare Plus Blue PPO Essential (PPO)
|
$9.00 |
$200 |
No |
5 |
Tier 5 |
29% | n/a | P Q:3 /28Days | $5,411.16 |
Browse Plan Formulary |
Medicare Plus Blue PPO Essential (PPO)
|
$9.00 |
$200 |
No |
5 |
Tier 5 |
29% | n/a | P Q:3 /28Days | $5,420.32 |
Browse Plan Formulary |
Medicare Plus Blue PPO Essential (PPO)
|
$9.00 |
$200 |
No |
5 |
Tier 5 |
29% | n/a | P Q:3 /28Days | $5,391.38 |
Browse Plan Formulary |
PriorityMedicare Ideal (PPO)
|
$14.00 |
$125 |
No |
5 |
Tier 5 |
30% | n/a | P Q:2 /28Days | $5,415.40 |
Browse Plan Formulary |
PriorityMedicare Ideal (PPO)
|
$14.00 |
$125 |
No |
5 |
Tier 5 |
30% | n/a | P Q:2 /28Days | $5,540.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
PriorityMedicare Ideal (PPO)
|
$14.00 |
$125 |
No |
5 |
Tier 5 |
30% | n/a | P Q:2 /28Days | $5,405.20 |
Browse Plan Formulary |
PriorityMedicare Ideal (PPO)
|
$14.00 |
$125 |
No |
5 |
Tier 5 |
30% | n/a | P Q:2 /28Days | $5,490.68 |
Browse Plan Formulary |
PriorityMedicare Ideal (PPO)
|
$14.00 |
$125 |
No |
5 |
Tier 5 |
30% | n/a | P Q:2 /28Days | $5,467.16 |
Browse Plan Formulary |
HumanaChoice H8087-001 (PPO)
|
$19.00 |
$195 |
No |
5 |
Tier 5 |
29% | n/a | P Q:6 /28Days | $5,834.82 |
Browse Plan Formulary |
WellCare Extra Plus (HMO-POS D-SNP)
|
$19.40 |
$435 |
No |
5 |
Tier 5 |
25% | n/a | P Q:6 /28Days | $5,868.16 |
Browse Plan Formulary |
Humana Gold Plus SNP-DE H8908-005 (HMO D-SNP)
|
$20.20 |
$425 |
No |
5 |
Tier 5 |
25% | n/a | P Q:6 /28Days | $5,834.82 |
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 |
WellCare Plus (HMO)
|
$20.60 |
$435 |
No |
5 |
Tier 5 |
25% | n/a | P Q:6 /28Days | $5,868.16 |
Browse Plan Formulary |
BCN Advantage HMO HealthySaver (HMO)
|
$23.00 |
$100 |
No |
5 |
Tier 5 |
31% | n/a | P Q:3 /28Days | $5,375.16 |
Browse Plan Formulary |
BCN Advantage HMO HealthySaver (HMO)
|
$23.00 |
$100 |
No |
5 |
Tier 5 |
31% | n/a | P Q:3 /28Days | $5,357.22 |
Browse Plan Formulary |
BCN Advantage HMO HealthySaver (HMO)
|
$23.00 |
$100 |
No |
5 |
Tier 5 |
31% | n/a | P Q:3 /28Days | $5,288.02 |
Browse Plan Formulary |
HumanaChoice R3887-002 (Regional PPO)
|
$23.00 |
$210 |
No |
5 |
Tier 5 |
29% | n/a | P Q:6 /28Days | $5,834.82 |
Browse Plan Formulary |
Align Thrive (HMO I-SNP)
|
$30.20 |
$435 |
No |
1 |
Tier 1 |
25% | n/a | P | $5,564.54 |
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 |
Molina Medicare Complete Care (HMO D-SNP)
|
$30.20 |
$435 |
No |
5 |
Tier 5 |
25% | n/a | P Q:6 /28Days | $5,418.06 |
Browse Plan Formulary |
PriorityMedicare D-SNP (HMO D-SNP)
|
$30.20 |
$435 |
No |
5 |
Tier 5 |
$0.00 | $0.00 | P Q:2 /28Days | $5,450.82 |
Browse Plan Formulary |
UnitedHealthcare Dual Complete (HMO D-SNP)
|
$30.20 |
$435 |
No |
5 |
Tier 5 |
$0.00 | $0.00 | P | $5,848.56 |
Browse Plan Formulary |
Aetna Medicare Premier Plus (PPO)
|
$32.00 |
$0 |
No |
5 |
Tier 5 |
33% | n/a | P Q:6 /28Days | $5,605.68 |
Browse Plan Formulary |
PriorityMedicare Value (HMO-POS)
|
$42.00 |
$75 |
No |
5 |
Tier 5 |
31% | n/a | P Q:2 /28Days | $5,467.16 |
Browse Plan Formulary |
PriorityMedicare Value (HMO-POS)
|
$42.00 |
$75 |
No |
5 |
Tier 5 |
31% | n/a | P Q:2 /28Days | $5,415.40 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
PriorityMedicare Value (HMO-POS)
|
$42.00 |
$75 |
No |
5 |
Tier 5 |
31% | n/a | P Q:2 /28Days | $5,540.80 |
Browse Plan Formulary |
PriorityMedicare Value (HMO-POS)
|
$42.00 |
$75 |
No |
5 |
Tier 5 |
31% | n/a | P Q:2 /28Days | $5,405.20 |
Browse Plan Formulary |
PriorityMedicare Value (HMO-POS)
|
$42.00 |
$75 |
No |
5 |
Tier 5 |
31% | n/a | P Q:2 /28Days | $5,442.08 |
Browse Plan Formulary |
Humana Gold Plus H8908-001 (HMO)
|
$44.00 |
$0 |
No |
5 |
Tier 5 |
33% | n/a | P Q:6 /28Days | $5,834.82 |
Browse Plan Formulary |
BCN Advantage HMO ConnectedCare (HMO)
|
$56.00 |
$0 |
No |
5 |
Tier 5 |
33% | n/a | P Q:3 /28Days | $5,375.16 |
Browse Plan Formulary |
HAP Senior Plus Option 2 (PPO)
|
$56.00 |
$0 |
No |
5 |
Tier 5 |
33% | n/a | P | $5,464.94 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HAP Senior Plus Option 1 (HMO-POS)
|
$76.00 |
$0 |
No |
5 |
Tier 5 |
33% | n/a | P | $5,464.94 |
Browse Plan Formulary |
Medicare Plus Blue PPO Vitality (PPO)
|
$76.00 |
$100 |
No |
5 |
Tier 5 |
31% | n/a | P Q:3 /28Days | $5,391.38 |
Browse Plan Formulary |
Medicare Plus Blue PPO Vitality (PPO)
|
$76.00 |
$100 |
No |
5 |
Tier 5 |
31% | n/a | P Q:3 /28Days | $5,315.34 |
Browse Plan Formulary |
Medicare Plus Blue PPO Vitality (PPO)
|
$76.00 |
$100 |
No |
5 |
Tier 5 |
31% | n/a | P Q:3 /28Days | $5,307.14 |
Browse Plan Formulary |
Medicare Plus Blue PPO Vitality (PPO)
|
$76.00 |
$100 |
No |
5 |
Tier 5 |
31% | n/a | P Q:3 /28Days | $5,411.16 |
Browse Plan Formulary |
Medicare Plus Blue PPO Vitality (PPO)
|
$76.00 |
$100 |
No |
5 |
Tier 5 |
31% | n/a | P Q:3 /28Days | $5,420.32 |
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 |
PriorityMedicare Merit (PPO)
|
$85.00 |
$0 |
No |
5 |
Tier 5 |
33% | n/a | P Q:2 /28Days | $5,405.20 |
Browse Plan Formulary |
PriorityMedicare Merit (PPO)
|
$85.00 |
$0 |
No |
5 |
Tier 5 |
33% | n/a | P Q:2 /28Days | $5,490.68 |
Browse Plan Formulary |
PriorityMedicare Merit (PPO)
|
$85.00 |
$0 |
No |
5 |
Tier 5 |
33% | n/a | P Q:2 /28Days | $5,467.16 |
Browse Plan Formulary |
PriorityMedicare Merit (PPO)
|
$85.00 |
$0 |
No |
5 |
Tier 5 |
33% | n/a | P Q:2 /28Days | $5,415.40 |
Browse Plan Formulary |
PriorityMedicare Merit (PPO)
|
$85.00 |
$0 |
No |
5 |
Tier 5 |
33% | n/a | P Q:2 /28Days | $5,540.80 |
Browse Plan Formulary |
PriorityMedicare (HMO-POS)
|
$113.00 |
$0 |
No |
5 |
Tier 5 |
33% | n/a | P Q:2 /28Days | $5,442.08 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
PriorityMedicare (HMO-POS)
|
$113.00 |
$0 |
No |
5 |
Tier 5 |
33% | n/a | P Q:2 /28Days | $5,467.16 |
Browse Plan Formulary |
PriorityMedicare (HMO-POS)
|
$113.00 |
$0 |
No |
5 |
Tier 5 |
33% | n/a | P Q:2 /28Days | $5,415.40 |
Browse Plan Formulary |
PriorityMedicare (HMO-POS)
|
$113.00 |
$0 |
No |
5 |
Tier 5 |
33% | n/a | P Q:2 /28Days | $5,540.80 |
Browse Plan Formulary |
PriorityMedicare (HMO-POS)
|
$113.00 |
$0 |
No |
5 |
Tier 5 |
33% | n/a | P Q:2 /28Days | $5,405.20 |
Browse Plan Formulary |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$128.30 |
$0 |
No |
5 |
Tier 5 |
33% | n/a | P Q:3 /28Days | $5,315.34 |
Browse Plan Formulary |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$128.30 |
$0 |
No |
5 |
Tier 5 |
33% | n/a | P Q:3 /28Days | $5,309.68 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$128.30 |
$0 |
No |
5 |
Tier 5 |
33% | n/a | P Q:3 /28Days | $5,411.16 |
Browse Plan Formulary |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$128.30 |
$0 |
No |
5 |
Tier 5 |
33% | n/a | P Q:3 /28Days | $5,426.78 |
Browse Plan Formulary |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$128.30 |
$0 |
No |
5 |
Tier 5 |
33% | n/a | P Q:3 /28Days | $5,391.38 |
Browse Plan Formulary |
Medicare Plus Blue PPO Signature (PPO)
|
$134.00 |
$0 |
No |
5 |
Tier 5 |
33% | n/a | P Q:3 /28Days | $5,420.32 |
Browse Plan Formulary |
Medicare Plus Blue PPO Signature (PPO)
|
$134.00 |
$0 |
No |
5 |
Tier 5 |
33% | n/a | P Q:3 /28Days | $5,391.38 |
Browse Plan Formulary |
Medicare Plus Blue PPO Signature (PPO)
|
$134.00 |
$0 |
No |
5 |
Tier 5 |
33% | n/a | P Q:3 /28Days | $5,315.34 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue PPO Signature (PPO)
|
$134.00 |
$0 |
No |
5 |
Tier 5 |
33% | n/a | P Q:3 /28Days | $5,307.14 |
Browse Plan Formulary |
Medicare Plus Blue PPO Signature (PPO)
|
$134.00 |
$0 |
No |
5 |
Tier 5 |
33% | n/a | P Q:3 /28Days | $5,411.16 |
Browse Plan Formulary |
HAP Senior Plus Option 3 (PPO)
|
$149.00 |
$0 |
No |
5 |
Tier 5 |
33% | n/a | P | $5,464.94 |
Browse Plan Formulary |
HAP Senior Plus Option 2 (HMO-POS)
|
$181.00 |
$0 |
No |
5 |
Tier 5 |
33% | n/a | P | $5,464.94 |
Browse Plan Formulary |
PriorityMedicare Select (PPO)
|
$196.00 |
$0 |
No |
5 |
Tier 5 |
33% | n/a | P Q:2 /28Days | $5,415.40 |
Browse Plan Formulary |
PriorityMedicare Select (PPO)
|
$196.00 |
$0 |
No |
5 |
Tier 5 |
33% | n/a | P Q:2 /28Days | $5,540.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
PriorityMedicare Select (PPO)
|
$196.00 |
$0 |
No |
5 |
Tier 5 |
33% | n/a | P Q:2 /28Days | $5,405.20 |
Browse Plan Formulary |
PriorityMedicare Select (PPO)
|
$196.00 |
$0 |
No |
5 |
Tier 5 |
33% | n/a | P Q:2 /28Days | $5,490.68 |
Browse Plan Formulary |
PriorityMedicare Select (PPO)
|
$196.00 |
$0 |
No |
5 |
Tier 5 |
33% | n/a | P Q:2 /28Days | $5,467.16 |
Browse Plan Formulary |
HAP Senior Plus Option 4 (PPO)
|
$200.00 |
$0 |
No |
5 |
Tier 5 |
33% | n/a | P | $5,464.94 |
Browse Plan Formulary |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$263.00 |
$0 |
No |
5 |
Tier 5 |
33% | n/a | P Q:3 /28Days | $5,309.68 |
Browse Plan Formulary |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$263.00 |
$0 |
No |
5 |
Tier 5 |
33% | n/a | P Q:3 /28Days | $5,411.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$263.00 |
$0 |
No |
5 |
Tier 5 |
33% | n/a | P Q:3 /28Days | $5,426.78 |
Browse Plan Formulary |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$263.00 |
$0 |
No |
5 |
Tier 5 |
33% | n/a | P Q:3 /28Days | $5,391.38 |
Browse Plan Formulary |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$263.00 |
$0 |
No |
5 |
Tier 5 |
33% | n/a | P Q:3 /28Days | $5,315.34 |
Browse Plan Formulary |
Medicare Plus Blue PPO Assure (PPO)
|
$298.10 |
$0 |
No |
5 |
Tier 5 |
33% | n/a | P Q:3 /28Days | $5,391.38 |
Browse Plan Formulary |
Medicare Plus Blue PPO Assure (PPO)
|
$298.10 |
$0 |
No |
5 |
Tier 5 |
33% | n/a | P Q:3 /28Days | $5,315.34 |
Browse Plan Formulary |
Medicare Plus Blue PPO Assure (PPO)
|
$298.10 |
$0 |
No |
5 |
Tier 5 |
33% | n/a | P Q:3 /28Days | $5,307.14 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue PPO Assure (PPO)
|
$298.10 |
$0 |
No |
5 |
Tier 5 |
33% | n/a | P Q:3 /28Days | $5,411.16 |
Browse Plan Formulary |
Medicare Plus Blue PPO Assure (PPO)
|
$298.10 |
$0 |
No |
5 |
Tier 5 |
33% | n/a | P Q:3 /28Days | $5,420.32 |
Browse Plan Formulary |