Medica Prime Solution Thrift (Cost) in IA - H2450-030-0
Benefits & Contact Info
|
Adair |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in IA - H2450-030-0
Benefits & Contact Info
|
Adams |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in IA - H2450-030-0
Benefits & Contact Info
|
Allamakee |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in IA - H2450-030-0
Benefits & Contact Info
|
Audubon |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in IA - H2450-030-0
Benefits & Contact Info
|
Boone |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in IA - H2450-030-0
Benefits & Contact Info
|
Carroll |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in IA - H2450-030-0
Benefits & Contact Info
|
Cass |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in IA - H2450-030-0
Benefits & Contact Info
|
Clay |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in IA - H2450-030-0
Benefits & Contact Info
|
Crawford |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in IA - H2450-030-0
Benefits & Contact Info
|
Dickinson |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in IA - H2450-030-0
Benefits & Contact Info
|
Emmet |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in IA - H2450-030-0
Benefits & Contact Info
|
Fremont |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in IA - H2450-030-0
Benefits & Contact Info
|
Greene |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in IA - H2450-030-0
Benefits & Contact Info
|
Guthrie |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in IA - H2450-030-0
Benefits & Contact Info
|
Howard |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in IA - H2450-030-0
Benefits & Contact Info
|
Kossuth |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in IA - H2450-030-0
Benefits & Contact Info
|
Lyon |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in IA - H2450-030-0
Benefits & Contact Info
|
Mitchell |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in IA - H2450-030-0
Benefits & Contact Info
|
Monona |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in IA - H2450-030-0
Benefits & Contact Info
|
Montgomery |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in IA - H2450-030-0
Benefits & Contact Info
|
O'Brien |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in IA - H2450-030-0
Benefits & Contact Info
|
Osceola |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in IA - H2450-030-0
Benefits & Contact Info
|
Palo Alto |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in IA - H2450-030-0
Benefits & Contact Info
|
Plymouth |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in IA - H2450-030-0
Benefits & Contact Info
|
Shelby |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in IA - H2450-030-0
Benefits & Contact Info
|
Sioux |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in IA - H2450-030-0
Benefits & Contact Info
|
Union |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in IA - H2450-030-0
Benefits & Contact Info
|
Winnebago |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in IA - H2450-030-0
Benefits & Contact Info
|
Worth |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in KS - H2450-030-0
Benefits & Contact Info
|
Barber |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in KS - H2450-030-0
Benefits & Contact Info
|
Butler |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in KS - H2450-030-0
Benefits & Contact Info
|
Chase |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in KS - H2450-030-0
Benefits & Contact Info
|
Chautauqua |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in KS - H2450-030-0
Benefits & Contact Info
|
Coffey |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in KS - H2450-030-0
Benefits & Contact Info
|
Cowley |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in KS - H2450-030-0
Benefits & Contact Info
|
Elk |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in KS - H2450-030-0
Benefits & Contact Info
|
Graham |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in KS - H2450-030-0
Benefits & Contact Info
|
Greenwood |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in KS - H2450-030-0
Benefits & Contact Info
|
Harper |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in KS - H2450-030-0
Benefits & Contact Info
|
Harvey |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in KS - H2450-030-0
Benefits & Contact Info
|
Jackson |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in KS - H2450-030-0
Benefits & Contact Info
|
Jefferson |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in KS - H2450-030-0
Benefits & Contact Info
|
Jewell |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in KS - H2450-030-0
Benefits & Contact Info
|
Kingman |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in KS - H2450-030-0
Benefits & Contact Info
|
Lincoln |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in KS - H2450-030-0
Benefits & Contact Info
|
Lyon |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in KS - H2450-030-0
Benefits & Contact Info
|
Marion |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in KS - H2450-030-0
Benefits & Contact Info
|
Mitchell |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in KS - H2450-030-0
Benefits & Contact Info
|
Morris |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in KS - H2450-030-0
Benefits & Contact Info
|
Norton |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in KS - H2450-030-0
Benefits & Contact Info
|
Osage |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in KS - H2450-030-0
Benefits & Contact Info
|
Ottawa |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in KS - H2450-030-0
Benefits & Contact Info
|
Phillips |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in KS - H2450-030-0
Benefits & Contact Info
|
Pottawatomie |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in KS - H2450-030-0
Benefits & Contact Info
|
Republic |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in KS - H2450-030-0
Benefits & Contact Info
|
Smith |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in KS - H2450-030-0
Benefits & Contact Info
|
Stafford |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in KS - H2450-030-0
Benefits & Contact Info
|
Wabaunsee |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in KS - H2450-030-0
Benefits & Contact Info
|
Washington |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in KS - H2450-030-0
Benefits & Contact Info
|
Woodson |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in MN - H2450-030-0
Benefits & Contact Info
|
Aitkin |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in MN - H2450-030-0
Benefits & Contact Info
|
Carlton |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in MN - H2450-030-0
Benefits & Contact Info
|
Cook |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in MN - H2450-030-0
Benefits & Contact Info
|
Goodhue |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in MN - H2450-030-0
Benefits & Contact Info
|
Itasca |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in MN - H2450-030-0
Benefits & Contact Info
|
Kanabec |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in MN - H2450-030-0
Benefits & Contact Info
|
Koochiching |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in MN - H2450-030-0
Benefits & Contact Info
|
Lake |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in MN - H2450-030-0
Benefits & Contact Info
|
Le Sueur |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in MN - H2450-030-0
Benefits & Contact Info
|
McLeod |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in MN - H2450-030-0
Benefits & Contact Info
|
Meeker |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in MN - H2450-030-0
Benefits & Contact Info
|
Mille Lacs |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in MN - H2450-030-0
Benefits & Contact Info
|
Pine |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in MN - H2450-030-0
Benefits & Contact Info
|
Pipestone |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in MN - H2450-030-0
Benefits & Contact Info
|
Rice |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in MN - H2450-030-0
Benefits & Contact Info
|
Rock |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in MN - H2450-030-0
Benefits & Contact Info
|
St. Louis |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in MN - H2450-030-0
Benefits & Contact Info
|
Sibley |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in MN - H2450-030-0
Benefits & Contact Info
|
Stevens |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in MN - H2450-030-0
Benefits & Contact Info
|
Traverse |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in MN - H2450-030-0
Benefits & Contact Info
|
Yellow Medicine |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in MO - H2450-030-0
Benefits & Contact Info
|
Barry |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in MO - H2450-030-0
Benefits & Contact Info
|
McDonald |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in MO - H2450-030-0
Benefits & Contact Info
|
Vernon |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in ND - H2450-030-0
Benefits & Contact Info
|
Adams |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in ND - H2450-030-0
Benefits & Contact Info
|
Barnes |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in ND - H2450-030-0
Benefits & Contact Info
|
Benson |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in ND - H2450-030-0
Benefits & Contact Info
|
Billings |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in ND - H2450-030-0
Benefits & Contact Info
|
Bowman |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in ND - H2450-030-0
Benefits & Contact Info
|
Cass |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in ND - H2450-030-0
Benefits & Contact Info
|
Cavalier |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in ND - H2450-030-0
Benefits & Contact Info
|
Dickey |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in ND - H2450-030-0
Benefits & Contact Info
|
Dunn |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in ND - H2450-030-0
Benefits & Contact Info
|
Eddy |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in ND - H2450-030-0
Benefits & Contact Info
|
Emmons |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in ND - H2450-030-0
Benefits & Contact Info
|
Foster |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in ND - H2450-030-0
Benefits & Contact Info
|
Grant |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in ND - H2450-030-0
Benefits & Contact Info
|
Griggs |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in ND - H2450-030-0
Benefits & Contact Info
|
Hettinger |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in ND - H2450-030-0
Benefits & Contact Info
|
Kidder |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in ND - H2450-030-0
Benefits & Contact Info
|
LaMoure |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in ND - H2450-030-0
Benefits & Contact Info
|
Logan |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in ND - H2450-030-0
Benefits & Contact Info
|
McHenry |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in ND - H2450-030-0
Benefits & Contact Info
|
McIntosh |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in ND - H2450-030-0
Benefits & Contact Info
|
McLean |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in ND - H2450-030-0
Benefits & Contact Info
|
Mercer |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in ND - H2450-030-0
Benefits & Contact Info
|
Nelson |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in ND - H2450-030-0
Benefits & Contact Info
|
Oliver |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in ND - H2450-030-0
Benefits & Contact Info
|
Pembina |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in ND - H2450-030-0
Benefits & Contact Info
|
Pierce |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in ND - H2450-030-0
Benefits & Contact Info
|
Ramsey |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in ND - H2450-030-0
Benefits & Contact Info
|
Ransom |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in ND - H2450-030-0
Benefits & Contact Info
|
Richland |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in ND - H2450-030-0
Benefits & Contact Info
|
Rolette |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in ND - H2450-030-0
Benefits & Contact Info
|
Sargent |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in ND - H2450-030-0
Benefits & Contact Info
|
Sheridan |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in ND - H2450-030-0
Benefits & Contact Info
|
Sioux |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in ND - H2450-030-0
Benefits & Contact Info
|
Slope |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in ND - H2450-030-0
Benefits & Contact Info
|
Stark |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in ND - H2450-030-0
Benefits & Contact Info
|
Steele |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in ND - H2450-030-0
Benefits & Contact Info
|
Towner |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in ND - H2450-030-0
Benefits & Contact Info
|
Traill |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in ND - H2450-030-0
Benefits & Contact Info
|
Walsh |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in ND - H2450-030-0
Benefits & Contact Info
|
Ward |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in ND - H2450-030-0
Benefits & Contact Info
|
Wells |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in ND - H2450-030-0
Benefits & Contact Info
|
Williams |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in NE - H2450-030-0
Benefits & Contact Info
|
Banner |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in NE - H2450-030-0
Benefits & Contact Info
|
Box Butte |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in NE - H2450-030-0
Benefits & Contact Info
|
Boyd |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in NE - H2450-030-0
Benefits & Contact Info
|
Brown |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in NE - H2450-030-0
Benefits & Contact Info
|
Burt |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in NE - H2450-030-0
Benefits & Contact Info
|
Cheyenne |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in NE - H2450-030-0
Benefits & Contact Info
|
Colfax |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in NE - H2450-030-0
Benefits & Contact Info
|
Dawes |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in NE - H2450-030-0
Benefits & Contact Info
|
Fillmore |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in NE - H2450-030-0
Benefits & Contact Info
|
Gage |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in NE - H2450-030-0
Benefits & Contact Info
|
Johnson |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in NE - H2450-030-0
Benefits & Contact Info
|
Keya Paha |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in NE - H2450-030-0
Benefits & Contact Info
|
Kimball |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in NE - H2450-030-0
Benefits & Contact Info
|
Logan |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in NE - H2450-030-0
Benefits & Contact Info
|
Loup |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in NE - H2450-030-0
Benefits & Contact Info
|
Morrill |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in NE - H2450-030-0
Benefits & Contact Info
|
Otoe |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in NE - H2450-030-0
Benefits & Contact Info
|
Polk |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in NE - H2450-030-0
Benefits & Contact Info
|
Rock |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in NE - H2450-030-0
Benefits & Contact Info
|
Saline |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in NE - H2450-030-0
Benefits & Contact Info
|
Scotts Bluff |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in NE - H2450-030-0
Benefits & Contact Info
|
Seward |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in NE - H2450-030-0
Benefits & Contact Info
|
Sheridan |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in NE - H2450-030-0
Benefits & Contact Info
|
Sioux |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in NE - H2450-030-0
Benefits & Contact Info
|
York |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in OK - H2450-030-0
Benefits & Contact Info
|
Adair |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in OK - H2450-030-0
Benefits & Contact Info
|
Alfalfa |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in OK - H2450-030-0
Benefits & Contact Info
|
Delaware |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in OK - H2450-030-0
Benefits & Contact Info
|
Grant |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in OK - H2450-030-0
Benefits & Contact Info
|
Kay |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in OK - H2450-030-0
Benefits & Contact Info
|
Major |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in OK - H2450-030-0
Benefits & Contact Info
|
Noble |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in OK - H2450-030-0
Benefits & Contact Info
|
Ottawa |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Aurora |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Beadle |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Bennett |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Bon Homme |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Brown |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Brule |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Buffalo |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Butte |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Campbell |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Charles Mix |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Clark |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Clay |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Codington |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Corson |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Custer |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Davison |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Day |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Dewey |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Douglas |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Edmunds |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Fall River |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Faulk |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Grant |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Gregory |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Haakon |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Hand |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Hanson |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Harding |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Hughes |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Hutchinson |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Hyde |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Jackson |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Jerauld |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Jones |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Kingsbury |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Lake |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Lawrence |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Lincoln |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Lyman |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
McCook |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
McPherson |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Marshall |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Meade |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Mellette |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Miner |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Minnehaha |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Moody |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Oglala Lakota |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Pennington |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Perkins |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Potter |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Roberts |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Sanborn |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Spink |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Stanley |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Sully |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Todd |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Tripp |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Turner |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Union |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Walworth |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Yankton |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in SD - H2450-030-0
Benefits & Contact Info
|
Ziebach |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in WI - H2450-030-0
Benefits & Contact Info
|
Ashland |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in WI - H2450-030-0
Benefits & Contact Info
|
Barron |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in WI - H2450-030-0
Benefits & Contact Info
|
Bayfield |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in WI - H2450-030-0
Benefits & Contact Info
|
Buffalo |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in WI - H2450-030-0
Benefits & Contact Info
|
Burnett |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in WI - H2450-030-0
Benefits & Contact Info
|
Chippewa |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in WI - H2450-030-0
Benefits & Contact Info
|
Douglas |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in WI - H2450-030-0
Benefits & Contact Info
|
Dunn |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in WI - H2450-030-0
Benefits & Contact Info
|
Eau Claire |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in WI - H2450-030-0
Benefits & Contact Info
|
Iron |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in WI - H2450-030-0
Benefits & Contact Info
|
Jackson |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in WI - H2450-030-0
Benefits & Contact Info
|
Pepin |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in WI - H2450-030-0
Benefits & Contact Info
|
Pierce |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in WI - H2450-030-0
Benefits & Contact Info
|
Polk |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in WI - H2450-030-0
Benefits & Contact Info
|
Rusk |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in WI - H2450-030-0
Benefits & Contact Info
|
St. Croix |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in WI - H2450-030-0
Benefits & Contact Info
|
Sawyer |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in WI - H2450-030-0
Benefits & Contact Info
|
Washburn |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in WY - H2450-030-0
Benefits & Contact Info
|
Albany |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in WY - H2450-030-0
Benefits & Contact Info
|
Campbell |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in WY - H2450-030-0
Benefits & Contact Info
|
Crook |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in WY - H2450-030-0
Benefits & Contact Info
|
Goshen |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in WY - H2450-030-0
Benefits & Contact Info
|
Laramie |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in WY - H2450-030-0
Benefits & Contact Info
|
Niobrara |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medica Prime Solution Thrift (Cost) in WY - H2450-030-0
Benefits & Contact Info
|
Platte |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|
Medica Prime Solution Thrift (Cost) in WY - H2450-030-0
Benefits & Contact Info
|
Weston |
$43.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
-- |
|
|
|