BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Alachua |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 Browse Formulary |
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BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Baker |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 Browse Formulary |
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BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Bay |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 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 |
BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Bradford |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 Browse Formulary |
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BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Brevard |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 Browse Formulary |
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BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Broward |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 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 |
BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Calhoun |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 Browse Formulary |
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BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Charlotte |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 Browse Formulary |
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BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Citrus |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 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 |
BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Clay |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 Browse Formulary |
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BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Collier |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 Browse Formulary |
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BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Columbia |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 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 |
BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
DeSoto |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 Browse Formulary |
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BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Dixie |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 Browse Formulary |
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BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Duval |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 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 |
BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Escambia |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 Browse Formulary |
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BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Flagler |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 Browse Formulary |
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BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Franklin |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 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 |
BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Gadsden |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 Browse Formulary |
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BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Gilchrist |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 Browse Formulary |
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BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Glades |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 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 |
BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Gulf |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 Browse Formulary |
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BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Hamilton |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 Browse Formulary |
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BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Hardee |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 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 |
BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Hendry |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 Browse Formulary |
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BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Hernando |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 Browse Formulary |
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BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Highlands |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 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 |
BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Hillsborough |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 Browse Formulary |
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BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Holmes |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 Browse Formulary |
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BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Indian River |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 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 |
BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Jackson |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 Browse Formulary |
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BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Jefferson |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 Browse Formulary |
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BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Lafayette |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 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 |
BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Lake |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 Browse Formulary |
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BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Lee |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 Browse Formulary |
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BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Leon |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 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 |
BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Levy |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 Browse Formulary |
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BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Liberty |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 Browse Formulary |
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BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Madison |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 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 |
BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Manatee |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 Browse Formulary |
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BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Marion |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 Browse Formulary |
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BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Martin |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 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 |
BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Miami-Dade |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 Browse Formulary |
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BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Monroe |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 Browse Formulary |
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BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Nassau |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 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 |
BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Okaloosa |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 Browse Formulary |
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BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Okeechobee |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 Browse Formulary |
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BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Orange |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 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 |
BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
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Osceola |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 Browse Formulary |
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BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Palm Beach |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 Browse Formulary |
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BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Pasco |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 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 |
BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Pinellas |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 Browse Formulary |
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BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Polk |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 Browse Formulary |
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BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Putnam |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 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 |
BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
St. Johns |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 Browse Formulary |
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BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
St. Lucie |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 Browse Formulary |
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BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Santa Rosa |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 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 |
BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Sarasota |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 Browse Formulary |
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BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Seminole |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 Browse Formulary |
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BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Sumter |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 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 |
BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Suwannee |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 Browse Formulary |
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BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Taylor |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 Browse Formulary |
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BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Union |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 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 |
BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Volusia |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 Browse Formulary |
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BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Wakulla |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 Browse Formulary |
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BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Walton |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 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 |
BlueMedicare Choice (Regional PPO) in FL - R3332-001-0
Benefits & Contact Info
|
Washington |
$67.40 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 Browse Formulary |
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