Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Arkansas |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Ashley |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Baxter |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Benton |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Carroll |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Cleburne |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Conway |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Craighead |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Crawford |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Crittenden |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Cross |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Dallas |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Faulkner |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Franklin |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Fulton |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Garland |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Greene |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Hot Spring |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Independence |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Jackson |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Jefferson |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Johnson |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Lawrence |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Lee |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Logan |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Marion |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Montgomery |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Pope |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Prairie |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Pulaski |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Randolph |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Saline |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Scott |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Sebastian |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Stone |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Union |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Van Buren |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in AR - H8145-120-0
Benefit Details
|
Washington |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in KS - H8145-120-0
Benefit Details
|
Anderson |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in KS - H8145-120-0
Benefit Details
|
Bourbon |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in KS - H8145-120-0
Benefit Details
|
Butler |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in KS - H8145-120-0
Benefit Details
|
Chautauqua |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in KS - H8145-120-0
Benefit Details
|
Cherokee |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in KS - H8145-120-0
Benefit Details
|
Crawford |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in KS - H8145-120-0
Benefit Details
|
Doniphan |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in KS - H8145-120-0
Benefit Details
|
Elk |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in KS - H8145-120-0
Benefit Details
|
Geary |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in KS - H8145-120-0
Benefit Details
|
Greenwood |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in KS - H8145-120-0
Benefit Details
|
Harper |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in KS - H8145-120-0
Benefit Details
|
Harvey |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in KS - H8145-120-0
Benefit Details
|
Jackson |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in KS - H8145-120-0
Benefit Details
|
Johnson |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in KS - H8145-120-0
Benefit Details
|
Labette |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in KS - H8145-120-0
Benefit Details
|
Leavenworth |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in KS - H8145-120-0
Benefit Details
|
Neosho |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in KS - H8145-120-0
Benefit Details
|
Sedgwick |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in KS - H8145-120-0
Benefit Details
|
Wilson |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in KS - H8145-120-0
Benefit Details
|
Woodson |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in KS - H8145-120-0
Benefit Details
|
Wyandotte |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Atchison |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Barry |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Barton |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Benton |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Boone |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Callaway |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Camden |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Carroll |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Carter |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Cass |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Cedar |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Christian |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Clay |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Cole |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Crawford |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Dade |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Dallas |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
DeKalb |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Dent |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Douglas |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Gasconade |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Gentry |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Greene |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Grundy |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Henry |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Hickory |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Holt |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Iron |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Jackson |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Jasper |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Jefferson |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Laclede |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Lawrence |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
McDonald |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Madison |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Mercer |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Miller |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Mississippi |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Montgomery |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
New Madrid |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Newton |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Nodaway |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Ozark |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Pemiscot |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Perry |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Phelps |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Pike |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Platte |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Polk |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Pulaski |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Reynolds |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
St. Charles |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
St. Clair |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
St. Louis |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Stoddard |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Stone |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Taney |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Vernon |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Washington |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Worth |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
Wright |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in MO - H8145-120-0
Benefit Details
|
St. Louis City |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
Adair |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
Bryan |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
Caddo |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
Canadian |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
Cleveland |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
Craig |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
Delaware |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
Garvin |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
Grady |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
Haskell |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
Kingfisher |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
Latimer |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
Logan |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
Love |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
McClain |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
McIntosh |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
Marshall |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
Mayes |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
Murray |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
Muskogee |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
Oklahoma |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
Okmulgee |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
Ottawa |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
Pottawatomie |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
Seminole |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
Sequoyah |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
Tulsa |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
Wagoner |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
Washita |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-120 (PFFS) in OK - H8145-120-0
Benefit Details
|
Woodward |
$31.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|