Aetna Medicare Eagle (PPO) in IL - H5521-286-0
Benefit Details
|
Boone |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in IL - H5521-286-0
Benefit Details
|
Bureau |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in IL - H5521-286-0
Benefit Details
|
Carroll |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare Eagle (PPO) in IL - H5521-286-0
Benefit Details
|
Cook |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
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|
|
Aetna Medicare Eagle (PPO) in IL - H5521-286-0
Benefit Details
|
DeKalb |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
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|
Aetna Medicare Eagle (PPO) in IL - H5521-286-0
Benefit Details
|
DuPage |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
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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 |
Aetna Medicare Eagle (PPO) in IL - H5521-286-0
Benefit Details
|
Grundy |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
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|
Aetna Medicare Eagle (PPO) in IL - H5521-286-0
Benefit Details
|
Hancock |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
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|
|
Aetna Medicare Eagle (PPO) in IL - H5521-286-0
Benefit Details
|
Henderson |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare Eagle (PPO) in IL - H5521-286-0
Benefit Details
|
Henry |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
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|
|
Aetna Medicare Eagle (PPO) in IL - H5521-286-0
Benefit Details
|
Jo Daviess |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
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|
|
Aetna Medicare Eagle (PPO) in IL - H5521-286-0
Benefit Details
|
Kane |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare Eagle (PPO) in IL - H5521-286-0
Benefit Details
|
Kankakee |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
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|
|
Aetna Medicare Eagle (PPO) in IL - H5521-286-0
Benefit Details
|
Kendall |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
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|
|
Aetna Medicare Eagle (PPO) in IL - H5521-286-0
Benefit Details
|
Lake |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare Eagle (PPO) in IL - H5521-286-0
Benefit Details
|
Lee |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in IL - H5521-286-0
Benefit Details
|
McHenry |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
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|
|
Aetna Medicare Eagle (PPO) in IL - H5521-286-0
Benefit Details
|
Mercer |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare Eagle (PPO) in IL - H5521-286-0
Benefit Details
|
Ogle |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in IL - H5521-286-0
Benefit Details
|
Rock Island |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
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|
|
Aetna Medicare Eagle (PPO) in IL - H5521-286-0
Benefit Details
|
Stephenson |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare Eagle (PPO) in IL - H5521-286-0
Benefit Details
|
Warren |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in IL - H5521-286-0
Benefit Details
|
Whiteside |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
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Aetna Medicare Eagle (PPO) in IL - H5521-286-0
Benefit Details
|
Will |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare Eagle (PPO) in IL - H5521-286-0
Benefit Details
|
Winnebago |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
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Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Adams |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
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Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Allen |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Bartholomew |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
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Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Benton |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
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Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Blackford |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Boone |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Brown |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Carroll |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Cass |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
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Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Clay |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Clinton |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Daviess |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
DeKalb |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Delaware |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
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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 |
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Elkhart |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
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Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Fountain |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
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|
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Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Fulton |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Gibson |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Grant |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Greene |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Hamilton |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Hancock |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Hendricks |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Henry |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Howard |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Huntington |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Jackson |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Jasper |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Jay |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Jennings |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Johnson |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Knox |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Kosciusko |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Lagrange |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Lake |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
La Porte |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Lawrence |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Madison |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Marion |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Marshall |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Martin |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Miami |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Monroe |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Montgomery |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Morgan |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Newton |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Noble |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Owen |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Parke |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Pike |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Porter |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Posey |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Pulaski |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Putnam |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Randolph |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
St. Joseph |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Shelby |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Starke |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Steuben |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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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 |
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Sullivan |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Tippecanoe |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Tipton |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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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 |
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Vanderburgh |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Vermillion |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Vigo |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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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 |
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Wabash |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Warren |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Warrick |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
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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 |
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Wayne |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Wells |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
White |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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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 |
Aetna Medicare Eagle (PPO) in IN - H5521-286-0
Benefit Details
|
Whitley |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Alcona |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Alger |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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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 |
Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Allegan |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Alpena |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Antrim |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
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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 |
Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Arenac |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Baraga |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Bay |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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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 |
Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Benzie |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Berrien |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Branch |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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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 |
Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Calhoun |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Cass |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Charlevoix |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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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 |
Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Cheboygan |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Chippewa |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Clare |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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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 |
Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Clinton |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Crawford |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Delta |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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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 |
Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Dickinson |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Eaton |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Emmet |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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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 |
Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Genesee |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Gladwin |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Grand Traverse |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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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 |
Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Gratiot |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Hillsdale |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Houghton |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
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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 |
Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Huron |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
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Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Ingham |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
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Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Iosco |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
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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 |
Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Iron |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
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|
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Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Isabella |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
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|
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Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Jackson |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
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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 |
Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Kalamazoo |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
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Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Kalkaska |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
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Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Kent |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
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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 |
Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Keweenaw |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
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|
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Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Lake |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
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|
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Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Lapeer |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Leelanau |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Lenawee |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Livingston |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Luce |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Mackinac |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Macomb |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Manistee |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Marquette |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Menominee |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Midland |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Missaukee |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Monroe |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Montcalm |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Montmorency |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Muskegon |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Oakland |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Oceana |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Ogemaw |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Ontonagon |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Oscoda |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Otsego |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Ottawa |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Presque Isle |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Roscommon |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Saginaw |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
St. Clair |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
St. Joseph |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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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 |
Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Sanilac |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Schoolcraft |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Shiawassee |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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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 |
Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Tuscola |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Washtenaw |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Wayne |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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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 |
Aetna Medicare Eagle (PPO) in MI - H5521-286-0
Benefit Details
|
Wexford |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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Aetna Medicare Eagle (PPO) in WI - H5521-286-0
Benefit Details
|
Brown |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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Aetna Medicare Eagle (PPO) in WI - H5521-286-0
Benefit Details
|
Calumet |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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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 |
Aetna Medicare Eagle (PPO) in WI - H5521-286-0
Benefit Details
|
Columbia |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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Aetna Medicare Eagle (PPO) in WI - H5521-286-0
Benefit Details
|
Green |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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Aetna Medicare Eagle (PPO) in WI - H5521-286-0
Benefit Details
|
Green Lake |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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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 |
Aetna Medicare Eagle (PPO) in WI - H5521-286-0
Benefit Details
|
Kenosha |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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Aetna Medicare Eagle (PPO) in WI - H5521-286-0
Benefit Details
|
Kewaunee |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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Aetna Medicare Eagle (PPO) in WI - H5521-286-0
Benefit Details
|
Lafayette |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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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 |
Aetna Medicare Eagle (PPO) in WI - H5521-286-0
Benefit Details
|
Manitowoc |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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Aetna Medicare Eagle (PPO) in WI - H5521-286-0
Benefit Details
|
Marquette |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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Aetna Medicare Eagle (PPO) in WI - H5521-286-0
Benefit Details
|
Milwaukee |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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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 |
Aetna Medicare Eagle (PPO) in WI - H5521-286-0
Benefit Details
|
Outagamie |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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Aetna Medicare Eagle (PPO) in WI - H5521-286-0
Benefit Details
|
Ozaukee |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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Aetna Medicare Eagle (PPO) in WI - H5521-286-0
Benefit Details
|
Racine |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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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 |
Aetna Medicare Eagle (PPO) in WI - H5521-286-0
Benefit Details
|
Rock |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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Aetna Medicare Eagle (PPO) in WI - H5521-286-0
Benefit Details
|
Shawano |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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Aetna Medicare Eagle (PPO) in WI - H5521-286-0
Benefit Details
|
Sheboygan |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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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 |
Aetna Medicare Eagle (PPO) in WI - H5521-286-0
Benefit Details
|
Walworth |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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Aetna Medicare Eagle (PPO) in WI - H5521-286-0
Benefit Details
|
Washington |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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Aetna Medicare Eagle (PPO) in WI - H5521-286-0
Benefit Details
|
Waukesha |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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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 |
Aetna Medicare Eagle (PPO) in WI - H5521-286-0
Benefit Details
|
Waushara |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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Aetna Medicare Eagle (PPO) in WI - H5521-286-0
Benefit Details
|
Winnebago |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
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