HealthPartners Journey Dash (PPO) in MN - H4882-010-1
Benefits & Contact Info
|
Anoka |
$84.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,000 Browse Formulary |
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HealthPartners Journey Dash (PPO) in MN - H4882-010-1
Benefits & Contact Info
|
Benton |
$84.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,000 Browse Formulary |
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HealthPartners Journey Dash (PPO) in MN - H4882-010-1
Benefits & Contact Info
|
Carver |
$84.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,000 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HealthPartners Journey Dash (PPO) in MN - H4882-010-1
Benefits & Contact Info
|
Chisago |
$84.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,000 Browse Formulary |
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HealthPartners Journey Dash (PPO) in MN - H4882-010-1
Benefits & Contact Info
|
Dakota |
$84.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,000 Browse Formulary |
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HealthPartners Journey Dash (PPO) in MN - H4882-010-1
Benefits & Contact Info
|
Douglas |
$84.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,000 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HealthPartners Journey Dash (PPO) in MN - H4882-010-1
Benefits & Contact Info
|
Hennepin |
$84.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,000 Browse Formulary |
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HealthPartners Journey Dash (PPO) in MN - H4882-010-1
Benefits & Contact Info
|
Isanti |
$84.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,000 Browse Formulary |
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HealthPartners Journey Dash (PPO) in MN - H4882-010-1
Benefits & Contact Info
|
Kandiyohi |
$84.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,000 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HealthPartners Journey Dash (PPO) in MN - H4882-010-1
Benefits & Contact Info
|
Meeker |
$84.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,000 Browse Formulary |
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HealthPartners Journey Dash (PPO) in MN - H4882-010-1
Benefits & Contact Info
|
Morrison |
$84.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,000 Browse Formulary |
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HealthPartners Journey Dash (PPO) in MN - H4882-010-1
Benefits & Contact Info
|
Pope |
$84.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,000 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HealthPartners Journey Dash (PPO) in MN - H4882-010-1
Benefits & Contact Info
|
Ramsey |
$84.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,000 Browse Formulary |
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HealthPartners Journey Dash (PPO) in MN - H4882-010-1
Benefits & Contact Info
|
Redwood |
$84.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,000 Browse Formulary |
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HealthPartners Journey Dash (PPO) in MN - H4882-010-1
Benefits & Contact Info
|
Scott |
$84.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,000 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HealthPartners Journey Dash (PPO) in MN - H4882-010-1
Benefits & Contact Info
|
Sherburne |
$84.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,000 Browse Formulary |
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HealthPartners Journey Dash (PPO) in MN - H4882-010-1
Benefits & Contact Info
|
Stearns |
$84.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,000 Browse Formulary |
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HealthPartners Journey Dash (PPO) in MN - H4882-010-1
Benefits & Contact Info
|
Swift |
$84.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,000 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HealthPartners Journey Dash (PPO) in MN - H4882-010-1
Benefits & Contact Info
|
Todd |
$84.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,000 Browse Formulary |
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HealthPartners Journey Dash (PPO) in MN - H4882-010-1
Benefits & Contact Info
|
Wadena |
$84.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,000 Browse Formulary |
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HealthPartners Journey Dash (PPO) in MN - H4882-010-1
Benefits & Contact Info
|
Washington |
$84.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,000 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HealthPartners Journey Dash (PPO) in MN - H4882-010-1
Benefits & Contact Info
|
Wright |
$84.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,000 Browse Formulary |
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HealthPartners Journey Dash (PPO) in MN - H4882-010-2
Benefits & Contact Info
|
Aitkin |
$96.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,200 Browse Formulary |
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HealthPartners Journey Dash (PPO) in MN - H4882-010-2
Benefits & Contact Info
|
Becker |
$96.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,200 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HealthPartners Journey Dash (PPO) in MN - H4882-010-2
Benefits & Contact Info
|
Beltrami |
$96.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,200 Browse Formulary |
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HealthPartners Journey Dash (PPO) in MN - H4882-010-2
Benefits & Contact Info
|
Big Stone |
$96.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,200 Browse Formulary |
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HealthPartners Journey Dash (PPO) in MN - H4882-010-2
Benefits & Contact Info
|
Carlton |
$96.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,200 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HealthPartners Journey Dash (PPO) in MN - H4882-010-2
Benefits & Contact Info
|
Cass |
$96.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,200 Browse Formulary |
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HealthPartners Journey Dash (PPO) in MN - H4882-010-2
Benefits & Contact Info
|
Chippewa |
$96.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,200 Browse Formulary |
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HealthPartners Journey Dash (PPO) in MN - H4882-010-2
Benefits & Contact Info
|
Clay |
$96.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,200 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HealthPartners Journey Dash (PPO) in MN - H4882-010-2
Benefits & Contact Info
|
Clearwater |
$96.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,200 Browse Formulary |
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HealthPartners Journey Dash (PPO) in MN - H4882-010-2
Benefits & Contact Info
|
Cook |
$96.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,200 Browse Formulary |
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HealthPartners Journey Dash (PPO) in MN - H4882-010-2
Benefits & Contact Info
|
Crow Wing |
$96.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,200 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HealthPartners Journey Dash (PPO) in MN - H4882-010-2
Benefits & Contact Info
|
Grant |
$96.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,200 Browse Formulary |
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HealthPartners Journey Dash (PPO) in MN - H4882-010-2
Benefits & Contact Info
|
Hubbard |
$96.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,200 Browse Formulary |
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HealthPartners Journey Dash (PPO) in MN - H4882-010-2
Benefits & Contact Info
|
Itasca |
$96.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,200 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HealthPartners Journey Dash (PPO) in MN - H4882-010-2
Benefits & Contact Info
|
Kanabec |
$96.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,200 Browse Formulary |
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HealthPartners Journey Dash (PPO) in MN - H4882-010-2
Benefits & Contact Info
|
Kittson |
$96.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,200 Browse Formulary |
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HealthPartners Journey Dash (PPO) in MN - H4882-010-2
Benefits & Contact Info
|
Koochiching |
$96.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,200 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HealthPartners Journey Dash (PPO) in MN - H4882-010-2
Benefits & Contact Info
|
Lac qui Parle |
$96.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,200 Browse Formulary |
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HealthPartners Journey Dash (PPO) in MN - H4882-010-2
Benefits & Contact Info
|
Lake |
$96.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,200 Browse Formulary |
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HealthPartners Journey Dash (PPO) in MN - H4882-010-2
Benefits & Contact Info
|
Lake of the Woods |
$96.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,200 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HealthPartners Journey Dash (PPO) in MN - H4882-010-2
Benefits & Contact Info
|
Le Sueur |
$96.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,200 Browse Formulary |
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HealthPartners Journey Dash (PPO) in MN - H4882-010-2
Benefits & Contact Info
|
Lincoln |
$96.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,200 Browse Formulary |
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HealthPartners Journey Dash (PPO) in MN - H4882-010-2
Benefits & Contact Info
|
Lyon |
$96.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,200 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HealthPartners Journey Dash (PPO) in MN - H4882-010-2
Benefits & Contact Info
|
McLeod |
$96.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,200 Browse Formulary |
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HealthPartners Journey Dash (PPO) in MN - H4882-010-2
Benefits & Contact Info
|
Mahnomen |
$96.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,200 Browse Formulary |
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HealthPartners Journey Dash (PPO) in MN - H4882-010-2
Benefits & Contact Info
|
Marshall |
$96.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,200 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HealthPartners Journey Dash (PPO) in MN - H4882-010-2
Benefits & Contact Info
|
Mille Lacs |
$96.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,200 Browse Formulary |
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HealthPartners Journey Dash (PPO) in MN - H4882-010-2
Benefits & Contact Info
|
Murray |
$96.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,200 Browse Formulary |
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HealthPartners Journey Dash (PPO) in MN - H4882-010-2
Benefits & Contact Info
|
Nobles |
$96.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,200 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HealthPartners Journey Dash (PPO) in MN - H4882-010-2
Benefits & Contact Info
|
Norman |
$96.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,200 Browse Formulary |
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HealthPartners Journey Dash (PPO) in MN - H4882-010-2
Benefits & Contact Info
|
Otter Tail |
$96.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,200 Browse Formulary |
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HealthPartners Journey Dash (PPO) in MN - H4882-010-2
Benefits & Contact Info
|
Pennington |
$96.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,200 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HealthPartners Journey Dash (PPO) in MN - H4882-010-2
Benefits & Contact Info
|
Pine |
$96.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,200 Browse Formulary |
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HealthPartners Journey Dash (PPO) in MN - H4882-010-2
Benefits & Contact Info
|
Pipestone |
$96.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,200 Browse Formulary |
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HealthPartners Journey Dash (PPO) in MN - H4882-010-2
Benefits & Contact Info
|
Polk |
$96.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,200 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HealthPartners Journey Dash (PPO) in MN - H4882-010-2
Benefits & Contact Info
|
Red Lake |
$96.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,200 Browse Formulary |
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HealthPartners Journey Dash (PPO) in MN - H4882-010-2
Benefits & Contact Info
|
Renville |
$96.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,200 Browse Formulary |
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HealthPartners Journey Dash (PPO) in MN - H4882-010-2
Benefits & Contact Info
|
Rice |
$96.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,200 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HealthPartners Journey Dash (PPO) in MN - H4882-010-2
Benefits & Contact Info
|
Rock |
$96.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,200 Browse Formulary |
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HealthPartners Journey Dash (PPO) in MN - H4882-010-2
Benefits & Contact Info
|
Roseau |
$96.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,200 Browse Formulary |
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HealthPartners Journey Dash (PPO) in MN - H4882-010-2
Benefits & Contact Info
|
St. Louis |
$96.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,200 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HealthPartners Journey Dash (PPO) in MN - H4882-010-2
Benefits & Contact Info
|
Sibley |
$96.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,200 Browse Formulary |
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HealthPartners Journey Dash (PPO) in MN - H4882-010-2
Benefits & Contact Info
|
Stevens |
$96.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,200 Browse Formulary |
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HealthPartners Journey Dash (PPO) in MN - H4882-010-2
Benefits & Contact Info
|
Traverse |
$96.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,200 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HealthPartners Journey Dash (PPO) in MN - H4882-010-2
Benefits & Contact Info
|
Wilkin |
$96.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,200 Browse Formulary |
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HealthPartners Journey Dash (PPO) in MN - H4882-010-2
Benefits & Contact Info
|
Yellow Medicine |
$96.00 |
$250 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,200 Browse Formulary |
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