Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Alamance |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
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|
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Alexander |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
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Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Alleghany |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
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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 |
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Anson |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
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Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Ashe |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
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Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Avery |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
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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 |
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Beaufort |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
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Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Bertie |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
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Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Bladen |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
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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 |
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Brunswick |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
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Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Buncombe |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
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Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Burke |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
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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 |
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Cabarrus |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
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Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Caldwell |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
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Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Camden |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
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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 |
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Carteret |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
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Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Caswell |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
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Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Catawba |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
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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 |
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Chatham |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
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Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Cherokee |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
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Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Chowan |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Clay |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
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Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Cleveland |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
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Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Columbus |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Craven |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
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Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Cumberland |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
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Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Currituck |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Dare |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
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Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Davidson |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
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Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Davie |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Duplin |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
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Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Durham |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Edgecombe |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Forsyth |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
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|
|
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Franklin |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Gaston |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Gates |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Graham |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Granville |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Greene |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Guilford |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Halifax |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Harnett |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Haywood |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Henderson |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Hertford |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Hoke |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Hyde |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Iredell |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Jackson |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Johnston |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Jones |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Lee |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Lenoir |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Lincoln |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
McDowell |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Macon |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Madison |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Martin |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Mecklenburg |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Mitchell |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Montgomery |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Moore |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Nash |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
New Hanover |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Northampton |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Onslow |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Orange |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Pamlico |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Pasquotank |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Pender |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Perquimans |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Person |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Pitt |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Polk |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Randolph |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Richmond |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Robeson |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Rockingham |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Rowan |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Rutherford |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Sampson |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Scotland |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Stanly |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Stokes |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Surry |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Swain |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Transylvania |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Tyrrell |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Union |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Vance |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Wake |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Warren |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Washington |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Watauga |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Wayne |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Wilkes |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Wilson |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Yadkin |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in NC - R1390-003-0
Benefit Details
|
Yancey |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Accomack |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Albemarle |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Alleghany |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Amelia |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Amherst |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Appomattox |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Arlington |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Augusta |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Bath |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Bedford |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Bland |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Botetourt |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Brunswick |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Buchanan |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Buckingham |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Campbell |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Caroline |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Carroll |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Charles City |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Charlotte |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Chesterfield |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Clarke |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Craig |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Culpeper |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Cumberland |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Dickenson |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Dinwiddie |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Essex |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Fairfax |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Fauquier |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Floyd |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Fluvanna |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Franklin |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Frederick |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Giles |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Gloucester |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Goochland |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Grayson |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Greene |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Greensville |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Halifax |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Hanover |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Henrico |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Henry |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Highland |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Isle of Wight |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
James City |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
King and Queen |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
King George |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
King William |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Lancaster |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Lee |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Loudoun |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Louisa |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Lunenburg |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Madison |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Mathews |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Mecklenburg |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Middlesex |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Montgomery |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Nelson |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
New Kent |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Northampton |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Northumberland |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Nottoway |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Orange |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Page |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Patrick |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Pittsylvania |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Powhatan |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Prince Edward |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Prince George |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Prince William |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Pulaski |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Rappahannock |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Richmond |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Roanoke |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Rockbridge |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Rockingham |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Russell |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Scott |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Shenandoah |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Smyth |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Southampton |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Spotsylvania |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Stafford |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Surry |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Sussex |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Tazewell |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Warren |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Washington |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Westmoreland |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Wise |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Wythe |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
York |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Alexandria City |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Bristol City |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Buena Vista City |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Charlottesville City |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Chesapeake City |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Colonial Heights City |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Covington City |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Danville City |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Emporia City |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Fairfax City |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Falls Church City |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Franklin City |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Fredericksburg City |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Galax City |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Hampton City |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Harrisonburg City |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Hopewell City |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Lexington City |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Lynchburg City |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Manassas City |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Manassas Park City |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Martinsville City |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Newport News City |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Norfolk City |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Norton City |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Petersburg City |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Poquoson City |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Portsmouth City |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Richmond City |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Roanoke City |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Staunton City |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Suffolk City |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Virginia Beach City |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Waynesboro City |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Williamsburg City |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Winchester City |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Radford City |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Humana Honor R1390-003 (Regional PPO) in VA - R1390-003-0
Benefit Details
|
Salem City |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|