Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Alcona |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Allegan |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Alpena |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 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 |
Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Antrim |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Arenac |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Bay |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 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 |
Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Benzie |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Branch |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Calhoun |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 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 |
Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Charlevoix |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Cheboygan |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Clare |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 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 |
Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Crawford |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Emmet |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Genesee |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 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 |
Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Gladwin |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Grand Traverse |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Gratiot |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 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 |
Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Hillsdale |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Huron |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Iosco |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 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 |
Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Jackson |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Kalamazoo |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Kalkaska |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 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 |
Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Kent |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Lake |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Lapeer |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 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 |
Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Leelanau |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Lenawee |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Livingston |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 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 |
Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Macomb |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Manistee |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Mecosta |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 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 |
Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Missaukee |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Monroe |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Montcalm |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 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 |
Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Montmorency |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Muskegon |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Newaygo |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 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 |
Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Oakland |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Oceana |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Ogemaw |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 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 |
Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Osceola |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Oscoda |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Otsego |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 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 |
Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Ottawa |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Presque Isle |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Roscommon |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 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 |
Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Saginaw |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
St. Clair |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Sanilac |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 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 |
Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Shiawassee |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Tuscola |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Washtenaw |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 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 |
Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Wayne |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Molina Medicare Choice Care (HMO) in MI - H5926-006-0
Benefits & Contact Info
|
Wexford |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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