Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
Arkansas |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
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Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
Ashley |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
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Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
Bradley |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
Calhoun |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
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Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
Carroll |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
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Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
Chicot |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
Clark |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
Clay |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
Cleburne |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
Cleveland |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
Conway |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
Craighead |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
Crittenden |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
Cross |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
Dallas |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
Desha |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
Drew |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
Fulton |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
Garland |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
Grant |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
Greene |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
Hot Spring |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
Independence |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
Izard |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
Jackson |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
Jefferson |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
Lawrence |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
Lee |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
Lincoln |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
Lonoke |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
Marion |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
Mississippi |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
Monroe |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
Montgomery |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
Nevada |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
Newton |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
Ouachita |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
Perry |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
Phillips |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
Pike |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
Poinsett |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
Prairie |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
Pulaski |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
Randolph |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
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Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
St. Francis |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
Saline |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
Searcy |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
Sharp |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
Stone |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
Union |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
Van Buren |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
White |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
Woodruff |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare Giveback Dividend (HMO) in AR - H1416-064-0
Benefits & Contact Info
|
Yell |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|