Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Anderson |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Barren |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Boone |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Bourbon |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Boyd |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Bracken |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Breckinridge |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Bullitt |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Butler |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Campbell |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Carroll |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Carter |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Christian |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Clark |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Edmonson |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Fayette |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Floyd |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Franklin |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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|
Higher cost-sharing at standard network pharmacies. Details:
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Gallatin |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Grant |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Grayson |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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|
Higher cost-sharing at standard network pharmacies. Details:
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Greenup |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Hancock |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Hardin |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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|
Higher cost-sharing at standard network pharmacies. Details:
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Harrison |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Hart |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Henderson |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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|
Higher cost-sharing at standard network pharmacies. Details:
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Henry |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Hopkins |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Jefferson |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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|
Higher cost-sharing at standard network pharmacies. Details:
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Jessamine |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Kenton |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Knott |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Knox |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Larue |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Laurel |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Letcher |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Lewis |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Logan |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
McCracken |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
McCreary |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
McLean |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Madison |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Martin |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Mason |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Meade |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Montgomery |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Muhlenberg |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Nelson |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Nicholas |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Ohio |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Oldham |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Pendleton |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Pike |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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|
Higher cost-sharing at standard network pharmacies. Details:
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Pulaski |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Robertson |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Rowan |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Russell |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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|
Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Scott |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Shelby |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Spencer |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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|
Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Taylor |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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|
Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Todd |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Trimble |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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|
Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Union |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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|
Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Warren |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Wayne |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Webster |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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|
Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Whitley |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare SmartFit (PPO) in KY - H5521-442-0
Benefits & Contact Info
|
Woodford |
$0.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|