ARANESP 200MCG/ML VIAL (200MCG/ 1ML VIALSD) (NDC: 55513000601)
2021 Medicare Prescription Drug Plan (MAPD) Information
Click here for the Chart Legend |
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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 |
Align Connect (HMO C-SNP)
|
$0.00 |
$445 |
No |
4 |
Non-Preferred Brand |
$95.00 | n/a | P S | $6,330.36 |
Browse Plan Formulary select insulin pay $35 copay but not this drug |
BCN Advantage Prime Value (HMO-POS)
|
$0.00 |
$50 |
No |
5 |
Specialty Tier |
32% | n/a | P | $6,613.08 |
Browse Plan Formulary select insulin pay $35 copay but not this drug |
BCN Advantage Prime Value (HMO-POS)
|
$0.00 |
$50 |
No |
5 |
Specialty Tier |
32% | n/a | P | $6,193.52 |
Browse Plan Formulary select insulin pay $35 copay but not this drug |
BCN Advantage Prime Value (HMO-POS)
|
$0.00 |
$50 |
No |
5 |
Specialty Tier |
32% | n/a | P | $6,193.52 |
Browse Plan Formulary select insulin pay $35 copay but not this drug |
BCN Advantage Prime Value (HMO-POS)
|
$0.00 |
$50 |
No |
5 |
Specialty Tier |
32% | n/a | P | $6,193.52 |
Browse Plan Formulary select insulin pay $35 copay but not this drug |
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 Prime Value (HMO-POS)
|
$0.00 |
$50 |
No |
5 |
Specialty Tier |
32% | n/a | P | $6,193.52 |
Browse Plan Formulary select insulin pay $35 copay but not this drug |
Erickson Advantage Liberty with Drugs (HMO-POS)
|
$0.00 |
$400 |
No |
5 |
Specialty Tier |
25% | n/a | P | $6,613.04 |
Browse Plan Formulary select insulin pay $35 copay but not this drug |
HAP Primary Choice (HMO)
|
$0.00 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,613.08 |
Browse Plan Formulary select insulin pay $15-$35 copay but not this drug |
HAP Senior Plus (HMO)
|
$0.00 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,613.08 |
Browse Plan Formulary select insulin pay $15-$35 copay but not this drug |
HAP Senior Plus Option 1 (PPO)
|
$0.00 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,613.08 |
Browse Plan Formulary select insulin pay $15-$35 copay but not this drug |
Medicare Plus Blue PPO Essential (PPO)
|
$0.00 |
$100 |
No |
5 |
Specialty Tier |
31% | n/a | P | $6,613.08 |
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 |
Medicare Plus Blue PPO Essential (PPO)
|
$0.00 |
$100 |
No |
5 |
Specialty Tier |
31% | n/a | P | $6,193.00 |
Browse Plan Formulary |
Medicare Plus Blue PPO Essential (PPO)
|
$0.00 |
$100 |
No |
5 |
Specialty Tier |
31% | n/a | P | $6,193.00 |
Browse Plan Formulary |
Medicare Plus Blue PPO Essential (PPO)
|
$0.00 |
$100 |
No |
5 |
Specialty Tier |
31% | n/a | P | $6,193.00 |
Browse Plan Formulary |
Medicare Plus Blue PPO Essential (PPO)
|
$0.00 |
$100 |
No |
5 |
Specialty Tier |
31% | n/a | P | $6,193.00 |
Browse Plan Formulary |
PriorityMedicare Edge (PPO)
|
$0.00 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,163.68 |
Browse Plan Formulary |
PriorityMedicare Edge (PPO)
|
$0.00 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,471.92 |
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 Edge (PPO)
|
$0.00 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,163.68 |
Browse Plan Formulary |
PriorityMedicare Key (HMO-POS)
|
$0.00 |
$100 |
No |
5 |
Specialty Tier |
31% | n/a | P | $6,471.92 |
Browse Plan Formulary |
PriorityMedicare Key (HMO-POS)
|
$0.00 |
$100 |
No |
5 |
Specialty Tier |
31% | n/a | P | $6,163.08 |
Browse Plan Formulary |
PriorityMedicare Key (HMO-POS)
|
$0.00 |
$100 |
No |
5 |
Specialty Tier |
31% | n/a | P | $6,163.08 |
Browse Plan Formulary |
PriorityMedicare Key (HMO-POS)
|
$0.00 |
$100 |
No |
5 |
Specialty Tier |
31% | n/a | P | $6,163.08 |
Browse Plan Formulary |
PriorityMedicare Key (HMO-POS)
|
$0.00 |
$100 |
No |
5 |
Specialty Tier |
31% | n/a | P | $6,163.08 |
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 Vital (PPO)
|
$0.00 |
$350 |
No |
5 |
Specialty Tier |
26% | n/a | P | $6,471.92 |
Browse Plan Formulary |
PriorityMedicare Vital (PPO)
|
$0.00 |
$350 |
No |
5 |
Specialty Tier |
26% | n/a | P | $6,163.68 |
Browse Plan Formulary |
PriorityMedicare Vital (PPO)
|
$0.00 |
$350 |
No |
5 |
Specialty Tier |
26% | n/a | P | $6,163.68 |
Browse Plan Formulary |
Reliance Principle Plan (HMO)
|
$0.00 |
$125 |
No |
5 |
Specialty Tier |
30% | n/a | P | $6,435.92 |
Browse Plan Formulary select insulin pay $10 copay but not this drug |
Zing Choice MI (HMO)
|
$0.00 |
$0 |
No |
4 |
Non-Preferred Brand |
$95.00 | $200.00 | P S | $6,324.12 |
Browse Plan Formulary |
Zing Essential Wellness MI (HMO C-SNP)
|
$0.00 |
$0 |
No |
4 |
Non-Preferred Brand |
$95.00 | $200.00 | P S | $6,324.12 |
Browse Plan Formulary select insulin pay $35 copay but not this drug |
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 |
Zing Open Access MI (HMO-POS)
|
$0.00 |
$0 |
No |
4 |
Non-Preferred Brand |
$95.00 | $200.00 | P S | $6,324.12 |
Browse Plan Formulary |
BCN Advantage Community Value (HMO-POS)
|
$20.00 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,193.52 |
Browse Plan Formulary |
BCN Advantage Community Value (HMO-POS)
|
$20.00 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,613.08 |
Browse Plan Formulary |
PriorityMedicare Ideal (PPO)
|
$20.00 |
$125 |
No |
5 |
Specialty Tier |
30% | n/a | P | $6,471.92 |
Browse Plan Formulary |
PriorityMedicare Ideal (PPO)
|
$20.00 |
$125 |
No |
5 |
Specialty Tier |
30% | n/a | P | $6,163.68 |
Browse Plan Formulary |
PriorityMedicare Ideal (PPO)
|
$20.00 |
$125 |
No |
5 |
Specialty Tier |
30% | n/a | P | $6,163.68 |
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 |
PriorityMedicare Ideal (PPO)
|
$20.00 |
$125 |
No |
5 |
Specialty Tier |
30% | n/a | P | $6,163.68 |
Browse Plan Formulary |
PriorityMedicare Ideal (PPO)
|
$20.00 |
$125 |
No |
5 |
Specialty Tier |
30% | n/a | P | $6,163.68 |
Browse Plan Formulary |
Erickson Advantage Guardian (HMO-POS I-SNP)
|
$28.80 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,613.04 |
Browse Plan Formulary select insulin pay $28 copay but not this drug |
Align Thrive (HMO I-SNP)
|
$30.10 |
$445 |
No |
1 |
Tier 1 |
25% | n/a | P S | $6,330.36 |
Browse Plan Formulary |
HAP Empowered Duals (HMO D-SNP)
|
$30.10 |
$445 |
No |
5 |
Tier 5 |
$0.00 | $0.00 | P | $6,613.08 |
Browse Plan Formulary |
Longevity Health Plan (HMO I-SNP)
|
$30.10 |
$445 |
No |
1 |
Tier 1 |
25% | n/a | P S | $6,330.36 |
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 D-SNP (HMO D-SNP)
|
$30.10 |
$445 |
No |
5 |
Tier 5 |
$0.00 | $0.00 | P | $6,516.52 |
Browse Plan Formulary |
Reliance Dual Care Plus (HMO D-SNP)
|
$30.10 |
$445 |
No |
1 |
Tier 1 |
$0.00 | $0.00 | P | $6,439.28 |
Browse Plan Formulary |
UnitedHealthcare Dual Complete (HMO D-SNP)
|
$30.10 |
$445 |
No |
5 |
Tier 5 |
$0.00 | $0.00 | P | $6,572.80 |
Browse Plan Formulary |
Reliance Cardinal Plan (HMO)
|
$40.00 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,435.92 |
Browse Plan Formulary select insulin pay $10 copay but not this drug |
PriorityMedicare Value (HMO-POS)
|
$45.00 |
$75 |
No |
5 |
Specialty Tier |
31% | n/a | P | $6,471.92 |
Browse Plan Formulary select insulin pay $15-$35 copay but not this drug |
PriorityMedicare Value (HMO-POS)
|
$45.00 |
$75 |
No |
5 |
Specialty Tier |
31% | n/a | P | $6,163.08 |
Browse Plan Formulary select insulin pay $15-$35 copay but not this drug |
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)
|
$45.00 |
$75 |
No |
5 |
Specialty Tier |
31% | n/a | P | $6,163.08 |
Browse Plan Formulary select insulin pay $15-$35 copay but not this drug |
PriorityMedicare Value (HMO-POS)
|
$45.00 |
$75 |
No |
5 |
Specialty Tier |
31% | n/a | P | $6,163.08 |
Browse Plan Formulary select insulin pay $15-$35 copay but not this drug |
PriorityMedicare Value (HMO-POS)
|
$45.00 |
$75 |
No |
5 |
Specialty Tier |
31% | n/a | P | $6,163.08 |
Browse Plan Formulary select insulin pay $15-$35 copay but not this drug |
BCN Advantage HMO ConnectedCare (HMO)
|
$57.00 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,613.08 |
Browse Plan Formulary select insulin pay $35 copay but not this drug |
HAP Senior Plus Option 2 (PPO)
|
$60.00 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,613.08 |
Browse Plan Formulary select insulin pay $15-$35 copay but not this drug |
Erickson Advantage Freedom (HMO-POS)
|
$70.00 |
$200 |
No |
5 |
Specialty Tier |
29% | n/a | P | $6,613.04 |
Browse Plan Formulary select insulin pay $35 copay but not this drug |
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 Vitality (PPO)
|
$77.00 |
$100 |
No |
5 |
Specialty Tier |
31% | n/a | P | $6,613.08 |
Browse Plan Formulary |
Medicare Plus Blue PPO Vitality (PPO)
|
$77.00 |
$100 |
No |
5 |
Specialty Tier |
31% | n/a | P | $6,193.00 |
Browse Plan Formulary |
Medicare Plus Blue PPO Vitality (PPO)
|
$77.00 |
$100 |
No |
5 |
Specialty Tier |
31% | n/a | P | $6,193.00 |
Browse Plan Formulary |
Medicare Plus Blue PPO Vitality (PPO)
|
$77.00 |
$100 |
No |
5 |
Specialty Tier |
31% | n/a | P | $6,193.00 |
Browse Plan Formulary |
Medicare Plus Blue PPO Vitality (PPO)
|
$77.00 |
$100 |
No |
5 |
Specialty Tier |
31% | n/a | P | $6,193.00 |
Browse Plan Formulary |
HAP Senior Plus Option 1 (HMO-POS)
|
$85.00 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,613.08 |
Browse Plan Formulary select insulin pay $15-$35 copay but not this drug |
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)
|
$90.00 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,163.68 |
Browse Plan Formulary |
PriorityMedicare Merit (PPO)
|
$90.00 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,163.68 |
Browse Plan Formulary |
PriorityMedicare Merit (PPO)
|
$90.00 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,471.92 |
Browse Plan Formulary |
PriorityMedicare Merit (PPO)
|
$90.00 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,163.68 |
Browse Plan Formulary |
PriorityMedicare Merit (PPO)
|
$90.00 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,163.68 |
Browse Plan Formulary |
HAP Senior Plus Henry Ford Tiered Access (HMO)
|
$95.00 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,613.08 |
Browse Plan Formulary select insulin pay $15-$35 copay but not this drug |
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)
|
$120.00 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,471.92 |
Browse Plan Formulary |
PriorityMedicare (HMO-POS)
|
$120.00 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,163.08 |
Browse Plan Formulary |
PriorityMedicare (HMO-POS)
|
$120.00 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,163.08 |
Browse Plan Formulary |
PriorityMedicare (HMO-POS)
|
$120.00 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,163.08 |
Browse Plan Formulary |
PriorityMedicare (HMO-POS)
|
$120.00 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,163.08 |
Browse Plan Formulary |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$129.00 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,193.52 |
Browse Plan Formulary select insulin pay $35 copay but not this drug |
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)
|
$129.00 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,613.08 |
Browse Plan Formulary select insulin pay $35 copay but not this drug |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$129.00 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,193.52 |
Browse Plan Formulary select insulin pay $35 copay but not this drug |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$129.00 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,193.52 |
Browse Plan Formulary select insulin pay $35 copay but not this drug |
BCN Advantage HMO-POS Classic (HMO-POS)
|
$129.00 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,193.52 |
Browse Plan Formulary select insulin pay $35 copay but not this drug |
Medicare Plus Blue PPO Signature (PPO)
|
$135.00 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,613.08 |
Browse Plan Formulary |
Medicare Plus Blue PPO Signature (PPO)
|
$135.00 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,193.00 |
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)
|
$135.00 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,193.00 |
Browse Plan Formulary |
Medicare Plus Blue PPO Signature (PPO)
|
$135.00 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,193.00 |
Browse Plan Formulary |
Medicare Plus Blue PPO Signature (PPO)
|
$135.00 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,193.00 |
Browse Plan Formulary |
HAP Senior Plus Option 3 (PPO)
|
$160.00 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,613.08 |
Browse Plan Formulary select insulin pay $15-$35 copay but not this drug |
HAP Senior Plus Option 2 (HMO-POS)
|
$190.00 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,613.08 |
Browse Plan Formulary select insulin pay $15-$35 copay but not this drug |
Erickson Advantage Champion (HMO-POS C-SNP)
|
$199.00 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,613.04 |
Browse Plan Formulary select insulin pay $35 copay but not this drug |
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 |
Erickson Advantage Signature with Drugs (HMO-POS)
|
$199.00 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,613.04 |
Browse Plan Formulary select insulin pay $35 copay but not this drug |
HAP Senior Plus Option 4 (PPO)
|
$200.00 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,613.08 |
Browse Plan Formulary select insulin pay $15-$35 copay but not this drug |
PriorityMedicare Select (PPO)
|
$206.00 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,471.92 |
Browse Plan Formulary |
PriorityMedicare Select (PPO)
|
$206.00 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,163.68 |
Browse Plan Formulary |
PriorityMedicare Select (PPO)
|
$206.00 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,163.68 |
Browse Plan Formulary |
PriorityMedicare Select (PPO)
|
$206.00 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,163.68 |
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 |
PriorityMedicare Select (PPO)
|
$206.00 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,163.68 |
Browse Plan Formulary |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$264.00 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,613.08 |
Browse Plan Formulary select insulin pay $35 copay but not this drug |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$264.00 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,193.52 |
Browse Plan Formulary select insulin pay $35 copay but not this drug |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$264.00 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,193.52 |
Browse Plan Formulary select insulin pay $35 copay but not this drug |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$264.00 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,193.52 |
Browse Plan Formulary select insulin pay $35 copay but not this drug |
BCN Advantage HMO-POS Prestige (HMO-POS)
|
$264.00 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,193.52 |
Browse Plan Formulary select insulin pay $35 copay but not this drug |
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)
|
$299.00 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,613.08 |
Browse Plan Formulary |
Medicare Plus Blue PPO Assure (PPO)
|
$299.00 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,193.00 |
Browse Plan Formulary |
Medicare Plus Blue PPO Assure (PPO)
|
$299.00 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,193.00 |
Browse Plan Formulary |
Medicare Plus Blue PPO Assure (PPO)
|
$299.00 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,193.00 |
Browse Plan Formulary |
Medicare Plus Blue PPO Assure (PPO)
|
$299.00 |
$0 |
No |
5 |
Specialty Tier |
33% | n/a | P | $6,193.00 |
Browse Plan Formulary |