Wellcare No Premium Open (PPO) in MI - H2117-001-0
Benefits & Contact Info
|
Allegan |
$0.00 |
$275 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,000 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare No Premium Open (PPO) in MI - H2117-001-0
Benefits & Contact Info
|
Arenac |
$0.00 |
$275 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,000 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare No Premium Open (PPO) in MI - H2117-001-0
Benefits & Contact Info
|
Barry |
$0.00 |
$275 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,000 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 No Premium Open (PPO) in MI - H2117-001-0
Benefits & Contact Info
|
Bay |
$0.00 |
$275 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,000 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare No Premium Open (PPO) in MI - H2117-001-0
Benefits & Contact Info
|
Branch |
$0.00 |
$275 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,000 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare No Premium Open (PPO) in MI - H2117-001-0
Benefits & Contact Info
|
Calhoun |
$0.00 |
$275 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,000 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 No Premium Open (PPO) in MI - H2117-001-0
Benefits & Contact Info
|
Cass |
$0.00 |
$275 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,000 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare No Premium Open (PPO) in MI - H2117-001-0
Benefits & Contact Info
|
Crawford |
$0.00 |
$275 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,000 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare No Premium Open (PPO) in MI - H2117-001-0
Benefits & Contact Info
|
Eaton |
$0.00 |
$275 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,000 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 No Premium Open (PPO) in MI - H2117-001-0
Benefits & Contact Info
|
Genesee |
$0.00 |
$275 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,000 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare No Premium Open (PPO) in MI - H2117-001-0
Benefits & Contact Info
|
Gladwin |
$0.00 |
$275 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,000 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare No Premium Open (PPO) in MI - H2117-001-0
Benefits & Contact Info
|
Gratiot |
$0.00 |
$275 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,000 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 No Premium Open (PPO) in MI - H2117-001-0
Benefits & Contact Info
|
Hillsdale |
$0.00 |
$275 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,000 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare No Premium Open (PPO) in MI - H2117-001-0
Benefits & Contact Info
|
Huron |
$0.00 |
$275 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,000 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare No Premium Open (PPO) in MI - H2117-001-0
Benefits & Contact Info
|
Ingham |
$0.00 |
$275 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,000 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 No Premium Open (PPO) in MI - H2117-001-0
Benefits & Contact Info
|
Iosco |
$0.00 |
$275 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,000 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare No Premium Open (PPO) in MI - H2117-001-0
Benefits & Contact Info
|
Jackson |
$0.00 |
$275 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,000 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare No Premium Open (PPO) in MI - H2117-001-0
Benefits & Contact Info
|
Kalamazoo |
$0.00 |
$275 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,000 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 No Premium Open (PPO) in MI - H2117-001-0
Benefits & Contact Info
|
Kalkaska |
$0.00 |
$275 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,000 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare No Premium Open (PPO) in MI - H2117-001-0
Benefits & Contact Info
|
Kent |
$0.00 |
$275 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,000 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare No Premium Open (PPO) in MI - H2117-001-0
Benefits & Contact Info
|
Lake |
$0.00 |
$275 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,000 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 No Premium Open (PPO) in MI - H2117-001-0
Benefits & Contact Info
|
Lapeer |
$0.00 |
$275 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,000 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare No Premium Open (PPO) in MI - H2117-001-0
Benefits & Contact Info
|
Livingston |
$0.00 |
$275 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,000 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare No Premium Open (PPO) in MI - H2117-001-0
Benefits & Contact Info
|
Macomb |
$0.00 |
$275 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,000 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 No Premium Open (PPO) in MI - H2117-001-0
Benefits & Contact Info
|
Mecosta |
$0.00 |
$275 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,000 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare No Premium Open (PPO) in MI - H2117-001-0
Benefits & Contact Info
|
Missaukee |
$0.00 |
$275 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,000 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare No Premium Open (PPO) in MI - H2117-001-0
Benefits & Contact Info
|
Monroe |
$0.00 |
$275 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,000 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 No Premium Open (PPO) in MI - H2117-001-0
Benefits & Contact Info
|
Montcalm |
$0.00 |
$275 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,000 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare No Premium Open (PPO) in MI - H2117-001-0
Benefits & Contact Info
|
Muskegon |
$0.00 |
$275 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,000 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare No Premium Open (PPO) in MI - H2117-001-0
Benefits & Contact Info
|
Newaygo |
$0.00 |
$275 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,000 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 No Premium Open (PPO) in MI - H2117-001-0
Benefits & Contact Info
|
Oakland |
$0.00 |
$275 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,000 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare No Premium Open (PPO) in MI - H2117-001-0
Benefits & Contact Info
|
Oceana |
$0.00 |
$275 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,000 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare No Premium Open (PPO) in MI - H2117-001-0
Benefits & Contact Info
|
Ogemaw |
$0.00 |
$275 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,000 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 No Premium Open (PPO) in MI - H2117-001-0
Benefits & Contact Info
|
Osceola |
$0.00 |
$275 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,000 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare No Premium Open (PPO) in MI - H2117-001-0
Benefits & Contact Info
|
Oscoda |
$0.00 |
$275 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,000 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare No Premium Open (PPO) in MI - H2117-001-0
Benefits & Contact Info
|
Otsego |
$0.00 |
$275 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,000 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 No Premium Open (PPO) in MI - H2117-001-0
Benefits & Contact Info
|
Ottawa |
$0.00 |
$275 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,000 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare No Premium Open (PPO) in MI - H2117-001-0
Benefits & Contact Info
|
Roscommon |
$0.00 |
$275 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,000 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare No Premium Open (PPO) in MI - H2117-001-0
Benefits & Contact Info
|
Saginaw |
$0.00 |
$275 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,000 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 No Premium Open (PPO) in MI - H2117-001-0
Benefits & Contact Info
|
St. Clair |
$0.00 |
$275 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,000 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare No Premium Open (PPO) in MI - H2117-001-0
Benefits & Contact Info
|
St. Joseph |
$0.00 |
$275 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,000 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare No Premium Open (PPO) in MI - H2117-001-0
Benefits & Contact Info
|
Sanilac |
$0.00 |
$275 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,000 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 No Premium Open (PPO) in MI - H2117-001-0
Benefits & Contact Info
|
Shiawassee |
$0.00 |
$275 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,000 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare No Premium Open (PPO) in MI - H2117-001-0
Benefits & Contact Info
|
Tuscola |
$0.00 |
$275 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,000 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare No Premium Open (PPO) in MI - H2117-001-0
Benefits & Contact Info
|
Van Buren |
$0.00 |
$275 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,000 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 No Premium Open (PPO) in MI - H2117-001-0
Benefits & Contact Info
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Washtenaw |
$0.00 |
$275 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,000 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
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Wellcare No Premium Open (PPO) in MI - H2117-001-0
Benefits & Contact Info
|
Wayne |
$0.00 |
$275 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,000 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
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Wellcare No Premium Open (PPO) in MI - H2117-001-0
Benefits & Contact Info
|
Wexford |
$0.00 |
$275 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,000 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|