METHADONE 5 MG/5 ML SOLUTION (30 mls ) (NDC: 00054355563)
2024 Medicare Prescription Drug Plan (MAPD) Information
Click here for the Chart Legend |
See your cost using a drug discount card: Compare prices at pharmacies near you |
Plan Name |
Monthly Prem. |
De- duct- ible | Does Plan Offer Additional Gap Coverage | Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Plan’s Avg. Retail Drug Price 30-Day |
Tier Nbr. |
Tier Desc. |
30-Day Prfrd. Pharm |
90-Day Mail Order |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
|
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0001 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0003 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0003 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0003 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0003 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AARP Medicare Advantage from UHC AL-0003 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0003 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0003 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0003 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0003 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0003 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AARP Medicare Advantage from UHC AL-0003 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0003 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0003 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0003 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0003 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0003 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AARP Medicare Advantage from UHC AL-0003 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0003 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0003 (HMO-POS)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0004 (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Essential (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $23.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Essential (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $23.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Essential (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $23.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Essential (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $23.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Essential (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $23.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $28.85 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $28.85 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $28.85 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $28.85 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $28.85 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $28.85 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $28.85 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $28.85 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $28.85 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $28.85 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $28.85 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $28.85 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $28.85 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $28.85 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $28.85 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $28.85 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $28.85 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $28.85 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $28.85 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $28.85 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $28.85 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $28.85 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $28.85 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $28.85 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $28.85 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $28.85 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $28.85 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $28.85 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $16.75 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $16.75 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $16.75 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $16.75 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $16.75 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $16.75 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $16.75 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $16.75 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $16.75 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $16.75 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $16.75 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $16.75 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Freedom (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Giveback Choice (PPO)
|
$0.00 |
$250 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
20% | 20% | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Giveback Choice (PPO)
|
$0.00 |
$250 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
20% | 20% | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Giveback Choice (PPO)
|
$0.00 |
$250 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
20% | 20% | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Giveback Choice (PPO)
|
$0.00 |
$250 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
20% | 20% | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Giveback Choice (PPO)
|
$0.00 |
$250 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
20% | 20% | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Giveback Choice (PPO)
|
$0.00 |
$250 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
20% | 20% | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Giveback Choice (PPO)
|
$0.00 |
$250 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
20% | 20% | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Giveback Choice (PPO)
|
$0.00 |
$250 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
20% | 20% | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Giveback Choice (PPO)
|
$0.00 |
$250 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
20% | 20% | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Giveback Choice (PPO)
|
$0.00 |
$250 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
20% | 20% | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Signature (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Signature (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Signature (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Signature (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred AL Medicare (HMO)
|
$0.00 |
$195 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
40% | 40% | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $21.10 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $21.10 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $21.10 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $21.10 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $21.10 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $21.10 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $21.10 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $21.10 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $21.10 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $21.10 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $21.10 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $21.10 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $21.10 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $21.10 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $21.10 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $21.10 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $21.10 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $21.10 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $21.10 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $21.10 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $21.10 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $21.10 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $21.10 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $21.10 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $21.10 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $21.10 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $21.10 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $21.10 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Access Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna True Choice Savings Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna True Choice Savings Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna True Choice Savings Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna True Choice Savings Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna True Choice Savings Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna True Choice Savings Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna True Choice Savings Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $26.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:1200 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Devoted CHOICE Alabama (PPO)
|
$0.00 |
$150 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CHOICE Alabama (PPO)
|
$0.00 |
$150 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CHOICE Alabama (PPO)
|
$0.00 |
$150 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CHOICE Alabama (PPO)
|
$0.00 |
$150 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CHOICE Alabama (PPO)
|
$0.00 |
$150 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CHOICE Alabama (PPO)
|
$0.00 |
$150 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Devoted CHOICE Alabama (PPO)
|
$0.00 |
$150 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CHOICE Alabama (PPO)
|
$0.00 |
$150 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CHOICE Alabama (PPO)
|
$0.00 |
$150 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CHOICE Alabama (PPO)
|
$0.00 |
$150 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CHOICE Alabama (PPO)
|
$0.00 |
$150 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CHOICE Alabama (PPO)
|
$0.00 |
$150 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Devoted CHOICE Alabama (PPO)
|
$0.00 |
$150 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CHOICE Alabama (PPO)
|
$0.00 |
$150 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CHOICE Alabama (PPO)
|
$0.00 |
$150 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CHOICE Alabama (PPO)
|
$0.00 |
$150 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CHOICE Alabama (PPO)
|
$0.00 |
$150 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CHOICE Alabama (PPO)
|
$0.00 |
$150 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Devoted CHOICE Alabama (PPO)
|
$0.00 |
$150 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CHOICE Alabama (PPO)
|
$0.00 |
$150 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CHOICE Alabama (PPO)
|
$0.00 |
$150 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CHOICE Alabama (PPO)
|
$0.00 |
$150 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CHOICE Alabama (PPO)
|
$0.00 |
$150 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $28.45 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CHOICE Alabama (PPO)
|
$0.00 |
$150 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $28.45 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Devoted CHOICE Alabama (PPO)
|
$0.00 |
$150 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $28.45 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CHOICE Alabama (PPO)
|
$0.00 |
$150 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $28.45 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CHOICE Alabama (PPO)
|
$0.00 |
$150 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $28.45 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CHOICE Alabama (PPO)
|
$0.00 |
$150 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $28.45 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CHOICE Alabama (PPO)
|
$0.00 |
$150 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $28.45 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CHOICE Alabama (PPO)
|
$0.00 |
$150 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $28.45 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Devoted CHOICE Alabama (PPO)
|
$0.00 |
$150 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $28.45 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CORE Alabama (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CORE Alabama (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CORE Alabama (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CORE Alabama (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CORE Alabama (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Devoted CORE Alabama (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CORE Alabama (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CORE Alabama (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CORE Alabama (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CORE Alabama (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CORE Alabama (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Devoted CORE Alabama (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CORE Alabama (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CORE Alabama (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CORE Alabama (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CORE Alabama (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CORE Alabama (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Devoted CORE Alabama (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CORE Alabama (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CORE Alabama (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CORE Alabama (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CORE Alabama (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted GIVEBACK Alabama (HMO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Devoted GIVEBACK Alabama (HMO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted GIVEBACK Alabama (HMO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted GIVEBACK Alabama (HMO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted GIVEBACK Alabama (HMO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted GIVEBACK Alabama (HMO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted GIVEBACK Alabama (HMO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Devoted GIVEBACK Alabama (HMO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted GIVEBACK Alabama (HMO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted GIVEBACK Alabama (HMO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted GIVEBACK Alabama (HMO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted GIVEBACK Alabama (HMO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted GIVEBACK Alabama (HMO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Devoted GIVEBACK Alabama (HMO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted GIVEBACK Alabama (HMO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted GIVEBACK Alabama (HMO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted GIVEBACK Alabama (HMO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted GIVEBACK Alabama (HMO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted GIVEBACK Alabama (HMO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Devoted GIVEBACK Alabama (HMO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted GIVEBACK Alabama (HMO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted GIVEBACK Alabama (HMO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted GIVEBACK Alabama (HMO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted GIVEBACK Alabama (HMO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted GIVEBACK Alabama (HMO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Devoted GIVEBACK Alabama (HMO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted GIVEBACK Alabama (HMO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted GIVEBACK Alabama (HMO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted GIVEBACK Alabama (HMO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted GIVEBACK Alabama (HMO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted GIVEBACK Alabama (HMO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $117.50 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Plus H5619-089 (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-269 (PPO)
|
$0.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care AL-0005 (HMO-POS C-SNP)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Classic (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $28.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Classic (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $28.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Classic (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $28.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
VIVA Medicare Classic (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $28.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Classic (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $28.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Infirmary Health Advantage (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $28.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Infirmary Health Advantage (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $28.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Plus (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Wellcare Complete - Giveback (HMO)
|
$0.00 |
$500 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Complete - Giveback (HMO)
|
$0.00 |
$500 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Complete - Giveback (HMO)
|
$0.00 |
$500 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Complete - Giveback (HMO)
|
$0.00 |
$500 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Complete - Giveback (HMO)
|
$0.00 |
$500 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Complete - Giveback (HMO)
|
$0.00 |
$500 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Wellcare Complete - Giveback (HMO)
|
$0.00 |
$500 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Complete - Giveback (HMO)
|
$0.00 |
$500 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Complete No Premium (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Complete No Premium (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Complete No Premium (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Complete No Premium (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Wellcare Complete No Premium (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Complete No Premium (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Complete No Premium (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Complete No Premium (HMO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $35.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Wellcare Giveback Open (PPO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Wellcare Giveback Open (PPO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Wellcare Giveback Open (PPO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Wellcare Giveback Open (PPO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Wellcare Giveback Open (PPO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Wellcare Giveback Open (PPO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
|
$0.00 |
$545 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Wellcare No Premium (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Wellcare No Premium (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Wellcare No Premium (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Wellcare No Premium (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Wellcare No Premium (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Wellcare No Premium (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO)
|
$0.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Wellcare No Premium Open (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Wellcare No Premium Open (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Wellcare No Premium Open (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Wellcare No Premium Open (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Wellcare No Premium Open (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Wellcare No Premium Open (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
|
$0.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$42.00 | $84.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-142 (PPO)
|
$7.00 |
$250 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $34.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-142 (PPO)
|
$7.00 |
$250 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HumanaChoice H5216-142 (PPO)
|
$7.00 |
$250 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $34.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-142 (PPO)
|
$7.00 |
$250 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-142 (PPO)
|
$7.00 |
$250 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $34.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-142 (PPO)
|
$7.00 |
$250 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-142 (PPO)
|
$7.00 |
$250 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $34.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-142 (PPO)
|
$7.00 |
$250 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-368 (PPO)
|
$7.00 |
$150* | No additional gap coverage, only the Donut Hole Discount | 3* |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Wellcare All Dual Assure (HMO D-SNP)
|
$19.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare All Dual Assure (HMO D-SNP)
|
$19.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare All Dual Assure (HMO D-SNP)
|
$19.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare All Dual Assure (HMO D-SNP)
|
$19.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare All Dual Assure (HMO D-SNP)
|
$19.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare All Dual Assure (HMO D-SNP)
|
$19.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Wellcare All Dual Assure (HMO D-SNP)
|
$19.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare All Dual Assure (HMO D-SNP)
|
$19.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare All Dual Assure (HMO D-SNP)
|
$19.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare All Dual Assure (HMO D-SNP)
|
$19.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare All Dual Assure (HMO D-SNP)
|
$19.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare All Dual Assure (HMO D-SNP)
|
$19.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Wellcare All Dual Assure (HMO D-SNP)
|
$19.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare All Dual Assure (HMO D-SNP)
|
$19.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare All Dual Assure (HMO D-SNP)
|
$19.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare All Dual Assure (HMO D-SNP)
|
$19.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare All Dual Assure (HMO D-SNP)
|
$19.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare All Dual Assure (HMO D-SNP)
|
$19.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Wellcare All Dual Assure (HMO D-SNP)
|
$19.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare All Dual Assure (HMO D-SNP)
|
$19.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare All Dual Assure (HMO D-SNP)
|
$19.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare All Dual Assure (HMO D-SNP)
|
$19.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare All Dual Assure (HMO D-SNP)
|
$19.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare All Dual Assure (HMO D-SNP)
|
$19.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Wellcare All Dual Assure (HMO D-SNP)
|
$19.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare All Dual Assure (HMO D-SNP)
|
$19.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare All Dual Assure (HMO D-SNP)
|
$19.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare All Dual Assure (HMO D-SNP)
|
$19.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare All Dual Assure (HMO D-SNP)
|
$19.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare All Dual Assure (HMO D-SNP)
|
$19.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Wellcare All Dual Assure (HMO D-SNP)
|
$19.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare All Dual Assure (HMO D-SNP)
|
$19.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare All Dual Assure (HMO D-SNP)
|
$19.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare All Dual Assure (HMO D-SNP)
|
$19.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare All Dual Assure (HMO D-SNP)
|
$19.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare All Dual Assure (HMO D-SNP)
|
$19.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Wellcare Assist (HMO)
|
$21.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $94.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist (HMO)
|
$21.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $94.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist (HMO)
|
$21.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $94.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist (HMO)
|
$21.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $94.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist (HMO)
|
$21.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $94.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist (HMO)
|
$21.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $94.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Wellcare Assist (HMO)
|
$21.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $94.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist (HMO)
|
$21.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $94.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist (HMO)
|
$21.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $94.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist (HMO)
|
$21.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $94.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist (HMO)
|
$21.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $94.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist (HMO)
|
$21.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $94.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Wellcare Assist (HMO)
|
$21.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $94.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist (HMO)
|
$21.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $94.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist (HMO)
|
$21.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $94.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist (HMO)
|
$21.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $94.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist (HMO)
|
$21.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $94.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist (HMO)
|
$21.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $94.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Wellcare Assist (HMO)
|
$21.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $94.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist (HMO)
|
$21.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $94.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist (HMO)
|
$21.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $94.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist (HMO)
|
$21.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $94.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist (HMO)
|
$21.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $94.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist (HMO)
|
$21.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $94.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Wellcare Assist (HMO)
|
$21.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $94.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist (HMO)
|
$21.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $94.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist (HMO)
|
$21.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $94.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist (HMO)
|
$21.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $94.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist (HMO)
|
$21.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $94.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist (HMO)
|
$21.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $94.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Wellcare Assist (HMO)
|
$21.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $94.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist (HMO)
|
$21.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $94.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist (HMO)
|
$21.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $94.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist (HMO)
|
$21.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $94.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist (HMO)
|
$21.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $94.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist (HMO)
|
$21.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $94.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Devoted DUAL PLUS Alabama (HMO D-SNP)
|
$23.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | P Q:450 /30Days | $28.45 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL PLUS Alabama (HMO D-SNP)
|
$23.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | P Q:450 /30Days | $28.45 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL PLUS Alabama (HMO D-SNP)
|
$23.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | P Q:450 /30Days | $28.45 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL PLUS Alabama (HMO D-SNP)
|
$23.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | P Q:450 /30Days | $28.45 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL PLUS Alabama (HMO D-SNP)
|
$23.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | P Q:450 /30Days | $28.45 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL PLUS Alabama (HMO D-SNP)
|
$23.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | P Q:450 /30Days | $28.45 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Devoted DUAL PLUS Alabama (HMO D-SNP)
|
$23.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | P Q:450 /30Days | $28.45 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL PLUS Alabama (HMO D-SNP)
|
$23.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | P Q:450 /30Days | $28.45 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL PLUS Alabama (HMO D-SNP)
|
$23.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | P Q:450 /30Days | $28.45 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access (HMO D-SNP)
|
$23.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access (HMO D-SNP)
|
$23.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access (HMO D-SNP)
|
$23.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Wellcare Dual Access (HMO D-SNP)
|
$23.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access (HMO D-SNP)
|
$23.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access (HMO D-SNP)
|
$23.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access (HMO D-SNP)
|
$23.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access (HMO D-SNP)
|
$23.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access (HMO D-SNP)
|
$23.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Wellcare Dual Access (HMO D-SNP)
|
$23.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access (HMO D-SNP)
|
$23.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access (HMO D-SNP)
|
$23.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access (HMO D-SNP)
|
$23.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access (HMO D-SNP)
|
$23.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access (HMO D-SNP)
|
$23.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Wellcare Dual Access (HMO D-SNP)
|
$23.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access (HMO D-SNP)
|
$23.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access (HMO D-SNP)
|
$23.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access (HMO D-SNP)
|
$23.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access (HMO D-SNP)
|
$23.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access (HMO D-SNP)
|
$23.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Wellcare Dual Access (HMO D-SNP)
|
$23.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access (HMO D-SNP)
|
$23.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access (HMO D-SNP)
|
$23.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access (HMO D-SNP)
|
$23.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access (HMO D-SNP)
|
$23.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access (HMO D-SNP)
|
$23.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Wellcare Dual Access (HMO D-SNP)
|
$23.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access (HMO D-SNP)
|
$23.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access (HMO D-SNP)
|
$23.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access (HMO D-SNP)
|
$23.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access (HMO D-SNP)
|
$23.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access (HMO D-SNP)
|
$23.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Wellcare Dual Access (HMO D-SNP)
|
$23.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access (HMO D-SNP)
|
$23.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access (HMO D-SNP)
|
$23.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL PLUS Alabama (HMO D-SNP)
|
$24.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL PLUS Alabama (HMO D-SNP)
|
$24.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL PLUS Alabama (HMO D-SNP)
|
$24.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Devoted DUAL PLUS Alabama (HMO D-SNP)
|
$24.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL PLUS Alabama (HMO D-SNP)
|
$24.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL PLUS Alabama (HMO D-SNP)
|
$24.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL PLUS Alabama (HMO D-SNP)
|
$24.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL PLUS Alabama (HMO D-SNP)
|
$24.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL PLUS Alabama (HMO D-SNP)
|
$24.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Devoted DUAL PLUS Alabama (HMO D-SNP)
|
$24.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL PLUS Alabama (HMO D-SNP)
|
$24.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL PLUS Alabama (HMO D-SNP)
|
$24.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL PLUS Alabama (HMO D-SNP)
|
$24.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL PLUS Alabama (HMO D-SNP)
|
$24.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL PLUS Alabama (HMO D-SNP)
|
$24.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Devoted DUAL PLUS Alabama (HMO D-SNP)
|
$24.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL PLUS Alabama (HMO D-SNP)
|
$24.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL PLUS Alabama (HMO D-SNP)
|
$24.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL PLUS Alabama (HMO D-SNP)
|
$24.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL PLUS Alabama (HMO D-SNP)
|
$24.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL PLUS Alabama (HMO D-SNP)
|
$24.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Devoted DUAL PLUS Alabama (HMO D-SNP)
|
$24.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Liberty (HMO D-SNP)
|
$25.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Liberty (HMO D-SNP)
|
$25.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Liberty (HMO D-SNP)
|
$25.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Liberty (HMO D-SNP)
|
$25.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Liberty (HMO D-SNP)
|
$25.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Wellcare Dual Liberty (HMO D-SNP)
|
$25.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Liberty (HMO D-SNP)
|
$25.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Liberty (HMO D-SNP)
|
$25.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Liberty (HMO D-SNP)
|
$25.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Liberty (HMO D-SNP)
|
$25.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Liberty (HMO D-SNP)
|
$25.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Wellcare Dual Liberty (HMO D-SNP)
|
$25.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Liberty (HMO D-SNP)
|
$25.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Liberty (HMO D-SNP)
|
$25.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Liberty (HMO D-SNP)
|
$25.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Liberty (HMO D-SNP)
|
$25.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Liberty (HMO D-SNP)
|
$25.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Wellcare Dual Liberty (HMO D-SNP)
|
$25.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Liberty (HMO D-SNP)
|
$25.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Liberty (HMO D-SNP)
|
$25.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Liberty (HMO D-SNP)
|
$25.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Liberty (HMO D-SNP)
|
$25.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Liberty (HMO D-SNP)
|
$25.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Wellcare Dual Liberty (HMO D-SNP)
|
$25.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Liberty (HMO D-SNP)
|
$25.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Liberty (HMO D-SNP)
|
$25.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Liberty (HMO D-SNP)
|
$25.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Liberty (HMO D-SNP)
|
$25.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Liberty (HMO D-SNP)
|
$25.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Wellcare Dual Liberty (HMO D-SNP)
|
$25.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Liberty (HMO D-SNP)
|
$25.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Liberty (HMO D-SNP)
|
$25.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Liberty (HMO D-SNP)
|
$25.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Liberty (HMO D-SNP)
|
$25.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Liberty (HMO D-SNP)
|
$25.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Wellcare Dual Liberty (HMO D-SNP)
|
$25.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access Open (PPO D-SNP)
|
$25.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access Open (PPO D-SNP)
|
$25.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access Open (PPO D-SNP)
|
$25.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access Open (PPO D-SNP)
|
$25.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access Open (PPO D-SNP)
|
$25.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Wellcare Dual Access Open (PPO D-SNP)
|
$25.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access Open (PPO D-SNP)
|
$25.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access Open (PPO D-SNP)
|
$25.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access Open (PPO D-SNP)
|
$25.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access Open (PPO D-SNP)
|
$25.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access Open (PPO D-SNP)
|
$25.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Wellcare Dual Access Open (PPO D-SNP)
|
$25.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access Open (PPO D-SNP)
|
$25.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access Open (PPO D-SNP)
|
$25.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access Open (PPO D-SNP)
|
$25.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access Open (PPO D-SNP)
|
$25.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access Open (PPO D-SNP)
|
$25.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Wellcare Dual Access Open (PPO D-SNP)
|
$25.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access Open (PPO D-SNP)
|
$25.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access Open (PPO D-SNP)
|
$25.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access Open (PPO D-SNP)
|
$25.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access Open (PPO D-SNP)
|
$25.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access Open (PPO D-SNP)
|
$25.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Wellcare Dual Access Open (PPO D-SNP)
|
$25.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access Open (PPO D-SNP)
|
$25.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access Open (PPO D-SNP)
|
$25.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access Open (PPO D-SNP)
|
$25.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access Open (PPO D-SNP)
|
$25.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access Open (PPO D-SNP)
|
$25.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Wellcare Dual Access Open (PPO D-SNP)
|
$25.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access Open (PPO D-SNP)
|
$25.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access Open (PPO D-SNP)
|
$25.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access Open (PPO D-SNP)
|
$25.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access Open (PPO D-SNP)
|
$25.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Dual Access Open (PPO D-SNP)
|
$25.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Wellcare Dual Access Open (PPO D-SNP)
|
$25.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
$0.00 | $0.00 | P Q:450 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL Alabama (HMO D-SNP)
|
$26.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $28.45 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL Alabama (HMO D-SNP)
|
$26.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $28.45 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL Alabama (HMO D-SNP)
|
$26.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $28.45 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL Alabama (HMO D-SNP)
|
$26.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $28.45 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL Alabama (HMO D-SNP)
|
$26.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $28.45 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Devoted DUAL Alabama (HMO D-SNP)
|
$26.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $28.45 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL Alabama (HMO D-SNP)
|
$26.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $28.45 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL Alabama (HMO D-SNP)
|
$26.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $28.45 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL Alabama (HMO D-SNP)
|
$26.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $28.45 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL Alabama (HMO D-SNP)
|
$26.80 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL Alabama (HMO D-SNP)
|
$26.80 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Devoted DUAL Alabama (HMO D-SNP)
|
$26.80 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL Alabama (HMO D-SNP)
|
$26.80 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL Alabama (HMO D-SNP)
|
$26.80 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL Alabama (HMO D-SNP)
|
$26.80 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL Alabama (HMO D-SNP)
|
$26.80 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL Alabama (HMO D-SNP)
|
$26.80 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Devoted DUAL Alabama (HMO D-SNP)
|
$26.80 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL Alabama (HMO D-SNP)
|
$26.80 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL Alabama (HMO D-SNP)
|
$26.80 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL Alabama (HMO D-SNP)
|
$26.80 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL Alabama (HMO D-SNP)
|
$26.80 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL Alabama (HMO D-SNP)
|
$26.80 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Devoted DUAL Alabama (HMO D-SNP)
|
$26.80 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL Alabama (HMO D-SNP)
|
$26.80 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL Alabama (HMO D-SNP)
|
$26.80 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL Alabama (HMO D-SNP)
|
$26.80 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL Alabama (HMO D-SNP)
|
$26.80 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL Alabama (HMO D-SNP)
|
$26.80 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Devoted DUAL Alabama (HMO D-SNP)
|
$26.80 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted DUAL Alabama (HMO D-SNP)
|
$26.80 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Value Plus (PPO)
|
$27.00 |
$300 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $141.00 | P Q:450 /30Days | $29.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare (HMO D-SNP)
|
$29.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
15% | 15% | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare (HMO D-SNP)
|
$29.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
15% | 15% | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare (HMO D-SNP)
|
$29.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
15% | 15% | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna TotalCare (HMO D-SNP)
|
$29.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
15% | 15% | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare (HMO D-SNP)
|
$29.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
15% | 15% | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare (HMO D-SNP)
|
$29.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
15% | 15% | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare (HMO D-SNP)
|
$29.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
15% | 15% | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare (HMO D-SNP)
|
$29.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
15% | 15% | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare (HMO D-SNP)
|
$29.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
15% | 15% | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna TotalCare (HMO D-SNP)
|
$29.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
15% | 15% | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare (HMO D-SNP)
|
$29.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
15% | 15% | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare (HMO D-SNP)
|
$29.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
15% | 15% | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare (HMO D-SNP)
|
$29.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
15% | 15% | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare (HMO D-SNP)
|
$29.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
15% | 15% | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare (HMO D-SNP)
|
$29.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
15% | 15% | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna TotalCare (HMO D-SNP)
|
$29.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
15% | 15% | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare (HMO D-SNP)
|
$29.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
15% | 15% | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare (HMO D-SNP)
|
$29.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
15% | 15% | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare (HMO D-SNP)
|
$29.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
15% | 15% | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare (HMO D-SNP)
|
$29.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
15% | 15% | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare (HMO D-SNP)
|
$29.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
15% | 15% | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna TotalCare (HMO D-SNP)
|
$29.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
15% | 15% | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare (HMO D-SNP)
|
$29.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
15% | 15% | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare (HMO D-SNP)
|
$29.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
15% | 15% | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare (HMO D-SNP)
|
$29.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
15% | 15% | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare (HMO D-SNP)
|
$29.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
15% | 15% | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare (HMO D-SNP)
|
$29.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
15% | 15% | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna TotalCare (HMO D-SNP)
|
$29.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
15% | 15% | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare (HMO D-SNP)
|
$29.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
15% | 15% | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare (HMO D-SNP)
|
$29.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
15% | 15% | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select Choice (PPO D-SNP)
|
$30.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Plus Medicare (HMO)
|
$32.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $30.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Plus Medicare (HMO)
|
$32.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $30.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna Preferred Plus Medicare (HMO)
|
$32.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $30.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Plus Medicare (HMO)
|
$32.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $30.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Plus Medicare (HMO)
|
$32.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $30.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Plus Medicare (HMO)
|
$32.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $30.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Plus Medicare (HMO)
|
$32.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $30.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Plus Medicare (HMO)
|
$32.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $30.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna Preferred Plus Medicare (HMO)
|
$32.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $30.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Plus Medicare (HMO)
|
$32.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $30.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Plus Medicare (HMO)
|
$32.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $30.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Plus Medicare (HMO)
|
$32.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $30.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Plus Medicare (HMO)
|
$32.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $30.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Plus Medicare (HMO)
|
$32.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $30.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna Preferred Plus Medicare (HMO)
|
$32.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $30.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Plus Medicare (HMO)
|
$32.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $30.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Plus Medicare (HMO)
|
$32.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Plus Medicare (HMO)
|
$32.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Plus Medicare (HMO)
|
$32.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Plus Medicare (HMO)
|
$32.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna Preferred Plus Medicare (HMO)
|
$32.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Plus Medicare (HMO)
|
$32.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Plus Medicare (HMO)
|
$32.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Plus Medicare (HMO)
|
$32.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Plus Medicare (HMO)
|
$32.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Plus Medicare (HMO)
|
$32.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna Preferred Plus Medicare (HMO)
|
$32.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Plus Medicare (HMO)
|
$32.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Plus Medicare (HMO)
|
$32.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Plus Medicare (HMO)
|
$32.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 4 |
Non-Preferred Drug |
$95.00 | $285.00 | Q:1200 /30Days | $20.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Nursing Home Plan EX-F001 (PPO I-SNP)
|
$32.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
25% | 25% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Nursing Home Plan EX-F001 (PPO I-SNP)
|
$32.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
25% | 25% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UHC Nursing Home Plan EX-F001 (PPO I-SNP)
|
$32.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
25% | 25% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Nursing Home Plan EX-F001 (PPO I-SNP)
|
$32.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
25% | 25% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Nursing Home Plan EX-F001 (PPO I-SNP)
|
$32.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
25% | 25% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Nursing Home Plan EX-F001 (PPO I-SNP)
|
$32.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
25% | 25% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Nursing Home Plan EX-F001 (PPO I-SNP)
|
$32.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
25% | 25% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Nursing Home Plan EX-F001 (PPO I-SNP)
|
$32.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
25% | 25% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UHC Nursing Home Plan EX-F001 (PPO I-SNP)
|
$32.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
25% | 25% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Nursing Home Plan EX-F001 (PPO I-SNP)
|
$32.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
25% | 25% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Nursing Home Plan EX-F001 (PPO I-SNP)
|
$32.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
25% | 25% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Nursing Home Plan EX-F001 (PPO I-SNP)
|
$32.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
25% | 25% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Nursing Home Plan EX-F001 (PPO I-SNP)
|
$32.10 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
25% | 25% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Select (HMO D-SNP)
|
$32.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna TotalCare Plus (HMO D-SNP)
|
$33.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
$0.00 | $0.00 | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare Plus (HMO D-SNP)
|
$33.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
$0.00 | $0.00 | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare Plus (HMO D-SNP)
|
$33.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
$0.00 | $0.00 | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare Plus (HMO D-SNP)
|
$33.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
$0.00 | $0.00 | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare Plus (HMO D-SNP)
|
$33.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
$0.00 | $0.00 | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare Plus (HMO D-SNP)
|
$33.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
$0.00 | $0.00 | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna TotalCare Plus (HMO D-SNP)
|
$33.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
$0.00 | $0.00 | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare Plus (HMO D-SNP)
|
$33.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
$0.00 | $0.00 | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare Plus (HMO D-SNP)
|
$33.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
$0.00 | $0.00 | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare Plus (HMO D-SNP)
|
$33.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
$0.00 | $0.00 | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare Plus (HMO D-SNP)
|
$33.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
$0.00 | $0.00 | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare Plus (HMO D-SNP)
|
$33.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
$0.00 | $0.00 | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna TotalCare Plus (HMO D-SNP)
|
$33.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
$0.00 | $0.00 | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare Plus (HMO D-SNP)
|
$33.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
$0.00 | $0.00 | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare Plus (HMO D-SNP)
|
$33.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
$0.00 | $0.00 | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare Plus (HMO D-SNP)
|
$33.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
$0.00 | $0.00 | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare Plus (HMO D-SNP)
|
$33.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
$0.00 | $0.00 | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare Plus (HMO D-SNP)
|
$33.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
$0.00 | $0.00 | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna TotalCare Plus (HMO D-SNP)
|
$33.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
$0.00 | $0.00 | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare Plus (HMO D-SNP)
|
$33.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
$0.00 | $0.00 | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare Plus (HMO D-SNP)
|
$33.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
$0.00 | $0.00 | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare Plus (HMO D-SNP)
|
$33.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
$0.00 | $0.00 | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare Plus (HMO D-SNP)
|
$33.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
$0.00 | $0.00 | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare Plus (HMO D-SNP)
|
$33.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
$0.00 | $0.00 | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Cigna TotalCare Plus (HMO D-SNP)
|
$33.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
$0.00 | $0.00 | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare Plus (HMO D-SNP)
|
$33.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
$0.00 | $0.00 | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare Plus (HMO D-SNP)
|
$33.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
$0.00 | $0.00 | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare Plus (HMO D-SNP)
|
$33.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
$0.00 | $0.00 | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare Plus (HMO D-SNP)
|
$33.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
$0.00 | $0.00 | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna TotalCare Plus (HMO D-SNP)
|
$33.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 4 |
Tier 4 |
$0.00 | $0.00 | Q:1200 /30Days | $21.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UHC Dual Complete AL-D001 (HMO-POS D-SNP)
|
$36.20 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$36.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$36.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$36.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$36.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$36.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$36.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$36.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$36.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$36.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$36.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$36.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$36.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$36.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$36.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$36.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$36.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$36.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$36.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$36.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$36.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$36.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$36.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$36.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$36.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$36.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$36.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$36.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$36.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$36.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$36.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$36.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$36.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$36.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$36.70 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Choice (PPO D-SNP)
|
$38.50 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AARP Medicare Advantage from UHC AL-0002 (HMO-POS)
|
$39.00 |
$0 | Yes, but No Gap Coverage for this drug. | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Signature Select (HMO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Signature Select (HMO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Signature Select (HMO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Signature Select (HMO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-D002 (PPO D-SNP)
|
$39.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$40.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$40.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$40.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$40.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$40.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$40.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$40.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$40.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$40.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$40.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$40.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$40.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$40.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$40.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$40.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$40.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$40.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$40.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$40.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$40.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$40.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$40.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$40.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$40.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$40.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$40.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$40.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$40.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$40.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$40.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$40.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$40.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Preferred (HMO D-SNP)
|
$40.30 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Care Advantage EX-E002 (PPO I-SNP)
|
$41.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Care Advantage EX-E002 (PPO I-SNP)
|
$41.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Care Advantage EX-E002 (PPO I-SNP)
|
$41.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UHC Care Advantage EX-E002 (PPO I-SNP)
|
$41.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Care Advantage EX-E002 (PPO I-SNP)
|
$41.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Care Advantage EX-E002 (PPO I-SNP)
|
$41.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
$47.00 | $131.00 | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Signature (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Signature (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Medicare Dual Signature (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Dual Signature (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | P Q:450 /30Days | $24.55 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus SNP-DE H5619-093 (HMO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Value Plus H5216-179 (PPO)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
21% | 21% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice SNP-DE H5216-370 (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
$0.00 | $0.00 | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
15% | 15% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage (PPO I-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 1 |
Tier 1 |
25% | 25% | None | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UHC Dual Complete AL-V001 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V001 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V001 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V001 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V001 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V001 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UHC Dual Complete AL-V001 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V001 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V001 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V001 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V001 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V001 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UHC Dual Complete AL-V001 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V001 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V001 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V001 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V001 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V001 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UHC Dual Complete AL-V001 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V001 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V001 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V001 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V001 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V001 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UHC Dual Complete AL-V001 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V001 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V001 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V001 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V001 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V001 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UHC Dual Complete AL-V001 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V001 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V001 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V001 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V001 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V001 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UHC Dual Complete AL-V001 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V001 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V001 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V001 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V001 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V001 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UHC Dual Complete AL-V001 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V001 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V001 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V001 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V001 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V001 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $28.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UHC Dual Complete AL-V002 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V002 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V002 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V002 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V002 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V002 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UHC Dual Complete AL-V002 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V002 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V002 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V002 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V002 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V002 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UHC Dual Complete AL-V002 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V002 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V002 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V002 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V002 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Dual Complete AL-V002 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UHC Dual Complete AL-V002 (HMO-POS D-SNP)
|
$41.40 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Tier 3 |
15% | 15% | Q:3600 /30Days | $29.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Extra Care (HMO D-SNP)
|
$41.40 |
$530 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
25% | 25% | P Q:450 /30Days | $28.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Extra Care (HMO D-SNP)
|
$41.40 |
$530 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
25% | 25% | P Q:450 /30Days | $28.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Extra Care (HMO D-SNP)
|
$41.40 |
$530 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
25% | 25% | P Q:450 /30Days | $28.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Extra Care (HMO D-SNP)
|
$41.40 |
$530 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
25% | 25% | P Q:450 /30Days | $28.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Extra Care (HMO D-SNP)
|
$41.40 |
$530 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
25% | 25% | P Q:450 /30Days | $28.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
VIVA Medicare Extra Value (HMO D-SNP)
|
$41.40 |
$529 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
25% | 25% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Extra Value (HMO D-SNP)
|
$41.40 |
$529 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
25% | 25% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Extra Value (HMO D-SNP)
|
$41.40 |
$529 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
25% | 25% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Extra Value (HMO D-SNP)
|
$41.40 |
$529 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
25% | 25% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Extra Value (HMO D-SNP)
|
$41.40 |
$529 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
25% | 25% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Extra Value (HMO D-SNP)
|
$41.40 |
$529 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
25% | 25% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
VIVA Medicare Extra Value (HMO D-SNP)
|
$41.40 |
$529 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
25% | 25% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Extra Value (HMO D-SNP)
|
$41.40 |
$529 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
25% | 25% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Extra Value (HMO D-SNP)
|
$41.40 |
$529 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
25% | 25% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Extra Value (HMO D-SNP)
|
$41.40 |
$529 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
25% | 25% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Extra Value (HMO D-SNP)
|
$41.40 |
$529 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
25% | 25% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Extra Value (HMO D-SNP)
|
$41.40 |
$529 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
25% | 25% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
VIVA Medicare Extra Value (HMO D-SNP)
|
$41.40 |
$529 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
25% | 25% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Extra Value (HMO D-SNP)
|
$41.40 |
$529 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
25% | 25% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Extra Value (HMO D-SNP)
|
$41.40 |
$529 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
25% | 25% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Extra Value (HMO D-SNP)
|
$41.40 |
$529 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
25% | 25% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Extra Value (HMO D-SNP)
|
$41.40 |
$529 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
25% | 25% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Extra Value (HMO D-SNP)
|
$41.40 |
$529 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
25% | 25% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
VIVA Medicare Extra Value (HMO D-SNP)
|
$41.40 |
$529 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
25% | 25% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Extra Value (HMO D-SNP)
|
$41.40 |
$529 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
25% | 25% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Extra Value (HMO D-SNP)
|
$41.40 |
$529 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
25% | 25% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Extra Value (HMO D-SNP)
|
$41.40 |
$529 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
25% | 25% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Extra Value (HMO D-SNP)
|
$41.40 |
$529 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
25% | 25% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Extra Value (HMO D-SNP)
|
$41.40 |
$529 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
25% | 25% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
VIVA Medicare Extra Value (HMO D-SNP)
|
$41.40 |
$529 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
25% | 25% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Extra Value (HMO D-SNP)
|
$41.40 |
$529 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
25% | 25% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Extra Value (HMO D-SNP)
|
$41.40 |
$529 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
25% | 25% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Extra Value (HMO D-SNP)
|
$41.40 |
$529 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
25% | 25% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Extra Value (HMO D-SNP)
|
$41.40 |
$529 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
25% | 25% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Extra Value (HMO D-SNP)
|
$41.40 |
$529 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
25% | 25% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
VIVA Medicare Extra Value (HMO D-SNP)
|
$41.40 |
$529 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
25% | 25% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Extra Value (HMO D-SNP)
|
$41.40 |
$529 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
25% | 25% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Extra Value (HMO D-SNP)
|
$41.40 |
$529 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
25% | 25% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Extra Value (HMO D-SNP)
|
$41.40 |
$529 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
25% | 25% | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Prime (HMO)
|
$46.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Prime (HMO)
|
$46.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
VIVA Medicare Prime (HMO)
|
$46.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Prime (HMO)
|
$46.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Prime (HMO)
|
$46.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Prime (HMO)
|
$46.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Prime (HMO)
|
$46.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Prime (HMO)
|
$46.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
VIVA Medicare Prime (HMO)
|
$46.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Prime (HMO)
|
$46.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Prime (HMO)
|
$46.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Prime (HMO)
|
$46.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Prime (HMO)
|
$46.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Prime (HMO)
|
$46.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
VIVA Medicare Prime (HMO)
|
$46.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Prime (HMO)
|
$46.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Prime (HMO)
|
$46.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Prime (HMO)
|
$46.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Prime (HMO)
|
$46.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Prime (HMO)
|
$46.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
VIVA Medicare Prime (HMO)
|
$46.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Prime (HMO)
|
$46.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Prime (HMO)
|
$46.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Prime (HMO)
|
$46.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Prime (HMO)
|
$46.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Prime (HMO)
|
$46.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
VIVA Medicare Prime (HMO)
|
$46.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Prime (HMO)
|
$46.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Prime (HMO)
|
$46.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Prime (HMO)
|
$46.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Prime (HMO)
|
$46.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Prime (HMO)
|
$46.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
VIVA Medicare Prime (HMO)
|
$46.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Prime (HMO)
|
$46.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$12.00 | $24.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice R7315-002 (Regional PPO)
|
$75.00 |
$545 | No additional gap coverage, only the Donut Hole Discount | 3 |
Preferred Brand |
20% | 20% | Q:3600 /30Days | $28.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Premier (HMO)
|
$96.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$8.00 | $16.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Premier (HMO)
|
$96.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$8.00 | $16.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Premier (HMO)
|
$96.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$8.00 | $16.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
VIVA Medicare Premier (HMO)
|
$96.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$8.00 | $16.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Premier (HMO)
|
$96.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$8.00 | $16.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Premier (HMO)
|
$96.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$8.00 | $16.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Premier (HMO)
|
$96.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$8.00 | $16.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Premier (HMO)
|
$96.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$8.00 | $16.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Premier (HMO)
|
$96.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$8.00 | $16.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
VIVA Medicare Premier (HMO)
|
$96.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$8.00 | $16.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Premier (HMO)
|
$96.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$8.00 | $16.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Premier (HMO)
|
$96.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$8.00 | $16.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Premier (HMO)
|
$96.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$8.00 | $16.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Premier (HMO)
|
$96.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$8.00 | $16.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Premier (HMO)
|
$96.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$8.00 | $16.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
VIVA Medicare Premier (HMO)
|
$96.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$8.00 | $16.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Premier (HMO)
|
$96.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$8.00 | $16.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Premier (HMO)
|
$96.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$8.00 | $16.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Premier (HMO)
|
$96.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$8.00 | $16.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Premier (HMO)
|
$96.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$8.00 | $16.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Premier (HMO)
|
$96.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$8.00 | $16.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
VIVA Medicare Premier (HMO)
|
$96.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$8.00 | $16.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Premier (HMO)
|
$96.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$8.00 | $16.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Premier (HMO)
|
$96.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$8.00 | $16.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Premier (HMO)
|
$96.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$8.00 | $16.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Premier (HMO)
|
$96.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$8.00 | $16.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Premier (HMO)
|
$96.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$8.00 | $16.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
VIVA Medicare Premier (HMO)
|
$96.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$8.00 | $16.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Premier (HMO)
|
$96.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$8.00 | $16.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Premier (HMO)
|
$96.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$8.00 | $16.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Premier (HMO)
|
$96.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$8.00 | $16.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Premier (HMO)
|
$96.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$8.00 | $16.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Premier (HMO)
|
$96.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$8.00 | $16.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
VIVA Medicare Premier (HMO)
|
$96.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$8.00 | $16.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Premier (HMO)
|
$96.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$8.00 | $16.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Premier (HMO)
|
$96.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$8.00 | $16.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Premier (HMO)
|
$96.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$8.00 | $16.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Premier (HMO)
|
$96.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$8.00 | $16.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
VIVA Medicare Premier (HMO)
|
$96.00 |
$0 | No additional gap coverage, only the Donut Hole Discount | 2 |
Generic |
$8.00 | $16.00 | P Q:450 /30Days | $17.95 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible | Additional Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Simpra Advantage Premier (PPO I-SNP)
|
$98.00 |
$150 | No additional gap coverage, only the Donut Hole Discount | 1 |
Preferred Generic |
$4.00 | $12.00 | Q:3600 /30Days | $50.00 |
Browse Plan Formulary all covered insulin pay $35 or less |