HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Allen |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Anderson |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Atchison |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Barber |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Barton |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Bourbon |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Brown |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Butler |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Chase |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Chautauqua |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Cherokee |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Cheyenne |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Clark |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Clay |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Cloud |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Coffey |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Comanche |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Cowley |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Crawford |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Decatur |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Dickinson |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Doniphan |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Douglas |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Edwards |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Elk |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Ellis |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Ellsworth |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Finney |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Ford |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Franklin |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Geary |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Gove |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Graham |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Grant |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Gray |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Greeley |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Greenwood |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Hamilton |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Harper |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Harvey |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Haskell |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Hodgeman |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Jackson |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Jefferson |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Jewell |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Johnson |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Kearny |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Kingman |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Kiowa |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Labette |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Lane |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Leavenworth |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Lincoln |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Linn |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Logan |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Lyon |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
McPherson |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Marion |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Marshall |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Meade |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Miami |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Mitchell |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Montgomery |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Morris |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Morton |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Nemaha |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Neosho |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Ness |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Norton |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Osage |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Osborne |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Ottawa |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Pawnee |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Phillips |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Pottawatomie |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Pratt |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Rawlins |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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|
HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Reno |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Republic |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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|
|
HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Rice |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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|
|
HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Riley |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Rooks |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
|
|
|
HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Rush |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
|
|
|
HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Russell |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Saline |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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|
HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Scott |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
|
|
|
HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Sedgwick |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Seward |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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|
|
HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Shawnee |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
|
|
|
HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Sheridan |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Sherman |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
|
|
|
HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Smith |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
|
|
|
HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Stafford |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Stanton |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
|
|
|
HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Stevens |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
|
|
|
HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Sumner |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Thomas |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
|
|
|
HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Trego |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
|
|
|
HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Wabaunsee |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Wallace |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
|
|
|
HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Washington |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
|
|
|
HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Wichita |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Wilson |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Woodson |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in KS - R4845-002-0
Benefits & Contact Info
|
Wyandotte |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Adair |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Alfalfa |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Atoka |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Beaver |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Beckham |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Blaine |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Bryan |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Caddo |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Canadian |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Carter |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Cherokee |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Choctaw |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Cimarron |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Cleveland |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Coal |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Comanche |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Cotton |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Craig |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Creek |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Custer |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Delaware |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Dewey |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Ellis |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Garfield |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Garvin |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Grady |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Grant |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Greer |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Harmon |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Harper |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Haskell |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Hughes |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Jackson |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Jefferson |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Johnston |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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HumanaChoice R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Kay |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Kingfisher |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Kiowa |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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HumanaChoice R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Latimer |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Le Flore |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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|
HumanaChoice R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Lincoln |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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|
HumanaChoice R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Logan |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Love |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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|
|
HumanaChoice R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
McClain |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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|
HumanaChoice R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
McCurtain |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
McIntosh |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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|
HumanaChoice R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Major |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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|
|
HumanaChoice R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Marshall |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Mayes |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
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|
HumanaChoice R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Murray |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Muskogee |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Noble |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Nowata |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Okfuskee |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Oklahoma |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Okmulgee |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Osage |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Ottawa |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Pawnee |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Payne |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Pittsburg |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Pontotoc |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Pottawatomie |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Pushmataha |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Roger Mills |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Rogers |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Seminole |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Sequoyah |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Stephens |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Texas |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Tillman |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Tulsa |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Wagoner |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Washington |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Washita |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% 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 R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Woods |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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HumanaChoice R4845-002 (Regional PPO) in OK - R4845-002-0
Benefits & Contact Info
|
Woodward |
$42.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $19.00 Generic: $20.00 Preferred Brand: 21% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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