HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Arkansas |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Ashley |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Baxter |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Benton |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Boone |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Bradley |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Calhoun |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Carroll |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Chicot |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Clark |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Clay |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Cleburne |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Cleveland |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Columbia |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Conway |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Craighead |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Crawford |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Crittenden |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Cross |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Dallas |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Desha |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Drew |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Faulkner |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Franklin |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Fulton |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Garland |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Grant |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Greene |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Hempstead |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Hot Spring |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Howard |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Independence |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Izard |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Jackson |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Jefferson |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Johnson |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Lafayette |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Lawrence |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Lee |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Lincoln |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Little River |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Logan |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Lonoke |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Madison |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Marion |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Miller |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Mississippi |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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|
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HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Monroe |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Montgomery |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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|
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HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Nevada |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Newton |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Ouachita |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Perry |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Phillips |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Pike |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Poinsett |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Polk |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Pope |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Prairie |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Pulaski |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Randolph |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
St. Francis |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Saline |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Scott |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Searcy |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Sebastian |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Sevier |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Sharp |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Stone |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Union |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Van Buren |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Washington |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
White |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Woodruff |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in AR - R1532-002-0
Benefits & Contact Info
|
Yell |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Adair |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Andrew |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Atchison |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Audrain |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Barry |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Barton |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Bates |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Benton |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Bollinger |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Boone |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Buchanan |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Butler |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Caldwell |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Callaway |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Camden |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Cape Girardeau |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Carroll |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Carter |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Cass |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Cedar |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Chariton |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Christian |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Clark |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Clay |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Clinton |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Cole |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Cooper |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Crawford |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Dade |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Dallas |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Daviess |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
DeKalb |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Dent |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Douglas |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Dunklin |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Franklin |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Gasconade |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Gentry |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Greene |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Grundy |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Harrison |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Henry |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Hickory |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Holt |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Howard |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Howell |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Iron |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Jackson |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Jasper |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Jefferson |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Johnson |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Knox |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Laclede |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Lafayette |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Lawrence |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Lewis |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Lincoln |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Linn |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Livingston |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
McDonald |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Macon |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Madison |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Maries |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Marion |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Mercer |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Miller |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Mississippi |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Moniteau |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Monroe |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Montgomery |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Morgan |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
New Madrid |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Newton |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Nodaway |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
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HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Oregon |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Osage |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Ozark |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Pemiscot |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Perry |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Pettis |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Phelps |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Pike |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Platte |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Polk |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Pulaski |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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|
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HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Putnam |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Ralls |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Randolph |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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|
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HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Ray |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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|
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HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Reynolds |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Ripley |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
St. Charles |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
St. Clair |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Ste. Genevieve |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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|
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HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
St. Francois |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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|
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HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
St. Louis |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Saline |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Schuyler |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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|
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HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Scotland |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Scott |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Shannon |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Shelby |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Stoddard |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Stone |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Sullivan |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Taney |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Texas |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Vernon |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Warren |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Washington |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Wayne |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Webster |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Worth |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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|
|
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
Wright |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R1532-002 (Regional PPO) in MO - R1532-002-0
Benefits & Contact Info
|
St. Louis City |
$62.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 18% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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|
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