WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Allen |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
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WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Anderson |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
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WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Ballard |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Barren |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
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WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Bell |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
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WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Boone |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Bourbon |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
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WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Boyd |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
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WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Boyle |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Breckinridge |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
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WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Bullitt |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
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WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Butler |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Caldwell |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
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WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Calloway |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
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WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Campbell |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Carlisle |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
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WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Carroll |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
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WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Carter |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Christian |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
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WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Clark |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
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WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Clay |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Daviess |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
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WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Edmonson |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
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WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Fayette |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Floyd |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
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WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Franklin |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
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WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Fulton |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Gallatin |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
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WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Garrard |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
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WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Grant |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Graves |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
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WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Grayson |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
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WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Greenup |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Hancock |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
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WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Hardin |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
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WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Harlan |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Harrison |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
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WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Hart |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
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WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Henderson |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Henry |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
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WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Hickman |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
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WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Hopkins |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Jefferson |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
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WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Jessamine |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
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WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Johnson |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
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|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Kenton |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
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WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Knott |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
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WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Knox |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
|
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|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Laurel |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
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WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Leslie |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
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WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Letcher |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
|
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|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Lincoln |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
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WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Logan |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
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WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
McCracken |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
|
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|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
McCreary |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
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WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
McLean |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
|
|
|
|
WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Madison |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Marshall |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
|
|
|
|
WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Meade |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
|
|
|
|
WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Mercer |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Montgomery |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
|
|
|
|
WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Muhlenberg |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
|
|
|
|
WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Nelson |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Ohio |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
|
|
|
|
WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Oldham |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
|
|
|
|
WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Owen |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Pendleton |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
|
|
|
|
WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Perry |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
|
|
|
|
WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Pike |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Pulaski |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
|
|
|
|
WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Scott |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
|
|
|
|
WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Shelby |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Simpson |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
|
|
|
|
WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Spencer |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
|
|
|
|
WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Taylor |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Todd |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
|
|
|
|
WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Trigg |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
|
|
|
|
WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Trimble |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Warren |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
|
|
|
|
WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Washington |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
|
|
|
|
WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Wayne |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Whitley |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
|
|
|
|
WellCare Compass (HMO) in KY - H9730-010-0
Benefit Details
|
Woodford |
$18.20 |
$445 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $5,000 Browse Formulary |
|
|
|
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