HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Alcona |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Alger |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Allegan |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Alpena |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Antrim |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Arenac |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Baraga |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Barry |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Bay |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Benzie |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Berrien |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Branch |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Calhoun |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Cass |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Charlevoix |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Cheboygan |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Chippewa |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Clare |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Clinton |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Crawford |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Delta |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Dickinson |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Eaton |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Emmet |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Genesee |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Gladwin |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Gogebic |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Grand Traverse |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Gratiot |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Hillsdale |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Houghton |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Huron |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Ingham |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Ionia |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Iosco |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Iron |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Isabella |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Jackson |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Kalamazoo |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Kalkaska |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Kent |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Keweenaw |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Lake |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Lapeer |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Leelanau |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Lenawee |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Livingston |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Luce |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Mackinac |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Macomb |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Manistee |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Marquette |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Mason |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Mecosta |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Menominee |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Midland |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Missaukee |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Monroe |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Montcalm |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Montmorency |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Muskegon |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Newaygo |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Oakland |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Oceana |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Ogemaw |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Ontonagon |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Osceola |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Oscoda |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Otsego |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Ottawa |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Presque Isle |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Roscommon |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Saginaw |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
St. Clair |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
St. Joseph |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Sanilac |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Schoolcraft |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Shiawassee |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Tuscola |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Van Buren |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Washtenaw |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Wayne |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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HumanaChoice R3887-002 (Regional PPO) in MI - R3887-002-0
Benefit Details
|
Wexford |
$87.00 |
$505 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $18.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 31% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
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