Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Arkansas |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Ashley |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Baxter |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a 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 |
Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Benton |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Boone |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Bradley |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a 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 |
Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Calhoun |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Carroll |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Clark |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a 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 |
Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Clay |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Cleburne |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Cleveland |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a 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 |
Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Columbia |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Conway |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Craighead |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a 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 |
Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Crawford |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Crittenden |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Cross |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a 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 |
Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Dallas |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Drew |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Faulkner |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a 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 |
Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Franklin |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Fulton |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Garland |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a 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 |
Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Grant |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Greene |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Hempstead |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a 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 |
Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Hot Spring |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Howard |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Independence |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a 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 |
Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Izard |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Jackson |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Jefferson |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a 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 |
Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Johnson |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Lafayette |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Lawrence |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a 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 |
Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Lee |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Lincoln |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Little River |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a 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 |
Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Logan |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Lonoke |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Madison |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a 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 |
Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Marion |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Miller |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Mississippi |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a 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 |
Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Montgomery |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Nevada |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Newton |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a 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 |
Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Ouachita |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Perry |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Phillips |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a 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 |
Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Pike |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Poinsett |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Polk |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Pope |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Prairie |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Pulaski |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Randolph |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
St. Francis |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Saline |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Scott |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Searcy |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Sebastian |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Sevier |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Sharp |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Stone |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Union |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Van Buren |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Washington |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-122 (PFFS) in AR - H8145-122-0
Benefits & Contact Info
|
Yell |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in IL - H8145-122-0
Benefits & Contact Info
|
Jersey |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in IL - H8145-122-0
Benefits & Contact Info
|
Monroe |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-122 (PFFS) in KS - H8145-122-0
Benefits & Contact Info
|
Allen |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in KS - H8145-122-0
Benefits & Contact Info
|
Anderson |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in KS - H8145-122-0
Benefits & Contact Info
|
Atchison |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-122 (PFFS) in KS - H8145-122-0
Benefits & Contact Info
|
Barton |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in KS - H8145-122-0
Benefits & Contact Info
|
Bourbon |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in KS - H8145-122-0
Benefits & Contact Info
|
Butler |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-122 (PFFS) in KS - H8145-122-0
Benefits & Contact Info
|
Chautauqua |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in KS - H8145-122-0
Benefits & Contact Info
|
Cherokee |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in KS - H8145-122-0
Benefits & Contact Info
|
Cowley |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-122 (PFFS) in KS - H8145-122-0
Benefits & Contact Info
|
Crawford |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in KS - H8145-122-0
Benefits & Contact Info
|
Dickinson |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in KS - H8145-122-0
Benefits & Contact Info
|
Doniphan |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-122 (PFFS) in KS - H8145-122-0
Benefits & Contact Info
|
Douglas |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in KS - H8145-122-0
Benefits & Contact Info
|
Elk |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in KS - H8145-122-0
Benefits & Contact Info
|
Ellsworth |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-122 (PFFS) in KS - H8145-122-0
Benefits & Contact Info
|
Franklin |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in KS - H8145-122-0
Benefits & Contact Info
|
Geary |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in KS - H8145-122-0
Benefits & Contact Info
|
Harper |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-122 (PFFS) in KS - H8145-122-0
Benefits & Contact Info
|
Harvey |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in KS - H8145-122-0
Benefits & Contact Info
|
Jackson |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in KS - H8145-122-0
Benefits & Contact Info
|
Jewell |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-122 (PFFS) in KS - H8145-122-0
Benefits & Contact Info
|
Johnson |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in KS - H8145-122-0
Benefits & Contact Info
|
Labette |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in KS - H8145-122-0
Benefits & Contact Info
|
Leavenworth |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-122 (PFFS) in KS - H8145-122-0
Benefits & Contact Info
|
Lyon |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in KS - H8145-122-0
Benefits & Contact Info
|
McPherson |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in KS - H8145-122-0
Benefits & Contact Info
|
Marion |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-122 (PFFS) in KS - H8145-122-0
Benefits & Contact Info
|
Marshall |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in KS - H8145-122-0
Benefits & Contact Info
|
Miami |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in KS - H8145-122-0
Benefits & Contact Info
|
Mitchell |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-122 (PFFS) in KS - H8145-122-0
Benefits & Contact Info
|
Montgomery |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in KS - H8145-122-0
Benefits & Contact Info
|
Nemaha |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in KS - H8145-122-0
Benefits & Contact Info
|
Neosho |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-122 (PFFS) in KS - H8145-122-0
Benefits & Contact Info
|
Norton |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in KS - H8145-122-0
Benefits & Contact Info
|
Osage |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in KS - H8145-122-0
Benefits & Contact Info
|
Ottawa |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-122 (PFFS) in KS - H8145-122-0
Benefits & Contact Info
|
Pawnee |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in KS - H8145-122-0
Benefits & Contact Info
|
Phillips |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in KS - H8145-122-0
Benefits & Contact Info
|
Pottawatomie |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-122 (PFFS) in KS - H8145-122-0
Benefits & Contact Info
|
Pratt |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in KS - H8145-122-0
Benefits & Contact Info
|
Reno |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in KS - H8145-122-0
Benefits & Contact Info
|
Republic |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-122 (PFFS) in KS - H8145-122-0
Benefits & Contact Info
|
Riley |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in KS - H8145-122-0
Benefits & Contact Info
|
Russell |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in KS - H8145-122-0
Benefits & Contact Info
|
Saline |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-122 (PFFS) in KS - H8145-122-0
Benefits & Contact Info
|
Sedgwick |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in KS - H8145-122-0
Benefits & Contact Info
|
Shawnee |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in KS - H8145-122-0
Benefits & Contact Info
|
Smith |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-122 (PFFS) in KS - H8145-122-0
Benefits & Contact Info
|
Sumner |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in KS - H8145-122-0
Benefits & Contact Info
|
Wilson |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in KS - H8145-122-0
Benefits & Contact Info
|
Woodson |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-122 (PFFS) in KS - H8145-122-0
Benefits & Contact Info
|
Wyandotte |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in MO - H8145-122-0
Benefits & Contact Info
|
Andrew |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in MO - H8145-122-0
Benefits & Contact Info
|
Bates |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-122 (PFFS) in MO - H8145-122-0
Benefits & Contact Info
|
Butler |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in MO - H8145-122-0
Benefits & Contact Info
|
Caldwell |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in MO - H8145-122-0
Benefits & Contact Info
|
Cass |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-122 (PFFS) in MO - H8145-122-0
Benefits & Contact Info
|
Clay |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in MO - H8145-122-0
Benefits & Contact Info
|
Clinton |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in MO - H8145-122-0
Benefits & Contact Info
|
Daviess |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-122 (PFFS) in MO - H8145-122-0
Benefits & Contact Info
|
Dunklin |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in MO - H8145-122-0
Benefits & Contact Info
|
Howard |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in MO - H8145-122-0
Benefits & Contact Info
|
Jackson |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-122 (PFFS) in MO - H8145-122-0
Benefits & Contact Info
|
Knox |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in MO - H8145-122-0
Benefits & Contact Info
|
Lafayette |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in MO - H8145-122-0
Benefits & Contact Info
|
Lincoln |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-122 (PFFS) in MO - H8145-122-0
Benefits & Contact Info
|
Linn |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in MO - H8145-122-0
Benefits & Contact Info
|
Macon |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in MO - H8145-122-0
Benefits & Contact Info
|
Maries |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-122 (PFFS) in MO - H8145-122-0
Benefits & Contact Info
|
Osage |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in MO - H8145-122-0
Benefits & Contact Info
|
Platte |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in MO - H8145-122-0
Benefits & Contact Info
|
Randolph |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-122 (PFFS) in MO - H8145-122-0
Benefits & Contact Info
|
Ripley |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in MO - H8145-122-0
Benefits & Contact Info
|
Saline |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in MO - H8145-122-0
Benefits & Contact Info
|
Scotland |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-122 (PFFS) in MO - H8145-122-0
Benefits & Contact Info
|
Texas |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in MO - H8145-122-0
Benefits & Contact Info
|
Webster |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Adair |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Alfalfa |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Atoka |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Blaine |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Bryan |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Caddo |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Canadian |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Carter |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Cherokee |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Choctaw |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a 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 |
Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Cleveland |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Coal |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Cotton |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a 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 |
Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Craig |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Creek |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Custer |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a 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 |
Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Delaware |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Dewey |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Garfield |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Garvin |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Grady |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Grant |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Greer |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Haskell |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Hughes |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Jefferson |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Johnston |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Kay |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Kingfisher |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
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Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Kiowa |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
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Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Latimer |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Le Flore |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
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Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Lincoln |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
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Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Logan |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Love |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
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Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
McClain |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
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Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
McCurtain |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
McIntosh |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
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Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Major |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
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|
|
Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Marshall |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Mayes |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
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Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Murray |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
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Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Muskogee |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Noble |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
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|
|
Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Nowata |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
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|
|
Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Okfuskee |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Oklahoma |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
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|
|
Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Okmulgee |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Osage |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Ottawa |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Pawnee |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Payne |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Pittsburg |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Pontotoc |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Pottawatomie |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Pushmataha |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Rogers |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Seminole |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Sequoyah |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
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|
|
Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Stephens |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Tillman |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a 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 |
Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Tulsa |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Wagoner |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Washita |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a 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 |
Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Woods |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Choice H8145-122 (PFFS) in OK - H8145-122-0
Benefits & Contact Info
|
Woodward |
$132.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
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