HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
Autauga |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
Barbour |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
Bibb |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
Blount |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
Bullock |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
Butler |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
Calhoun |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
Cherokee |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
Chilton |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
Choctaw |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
Cleburne |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
Coffee |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
Colbert |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
Conecuh |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
Cullman |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
Dale |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
Dallas |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
DeKalb |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
Elmore |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
Etowah |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
Fayette |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
Franklin |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
Geneva |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
Greene |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
Hale |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
Henry |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
Houston |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
Jackson |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
Jefferson |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
Lamar |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
Lauderdale |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
Lawrence |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
Limestone |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
Lowndes |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
Macon |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
Madison |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
Marengo |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
Marion |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
Marshall |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
Monroe |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
Montgomery |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
Morgan |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
Perry |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
Pickens |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
Pike |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
St. Clair |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
Shelby |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
Sumter |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
Talladega |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
Tuscaloosa |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
Walker |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
Washington |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
Wilcox |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice H5216-368 (PPO) in AL - H5216-368-0
Benefits & Contact Info
|
Winston |
$7.00 |
$150 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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