SEVELAMER 0.8 GM POWDER PACKET [RENVELA] (90 EA ) (NDC: 65862093090)
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 IA-0001 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0001 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0001 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0001 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0001 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0001 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0001 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0001 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0001 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0001 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IA-0001 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0001 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
|
Plan Name |
Monthly Prem. |
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 IA-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0004 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0004 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0004 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0004 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0004 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0004 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $170.15 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $170.15 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IL-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $170.15 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $170.15 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $170.15 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $170.15 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $170.15 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $170.15 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IL-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $170.15 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $170.15 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $170.15 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $170.15 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $170.15 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $170.15 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IL-001P (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-001P (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $170.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-001P (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-001P (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $170.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-001P (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-001P (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $170.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-001P (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-001P (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $170.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-001P (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-001P (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $170.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ST-0003 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0003 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 ST-0003 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0003 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ST-0003 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0003 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ST-0003 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0003 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ST-0003 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0003 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ST-0003 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0003 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ST-0003 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0003 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 ST-0003 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0003 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ST-0003 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0003 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ST-0003 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0003 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ST-0003 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0003 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ST-0003 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0003 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ST-0003 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0003 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 ST-0003 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0003 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ST-0003 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0003 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ST-0003 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0003 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ST-0003 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0003 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ST-0003 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0003 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ST-0003 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0003 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 ST-0003 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0003 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ST-0004 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0004 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ST-0004 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0004 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ST-0004 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0004 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ST-0004 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0004 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ST-0004 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0004 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 ST-0004 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0004 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ST-0004 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0004 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ST-0004 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0004 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ST-0004 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0004 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ST-0004 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0004 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ST-0004 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0004 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 ST-0004 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0004 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ST-0004 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0004 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ST-0004 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0004 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ST-0004 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0004 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ST-0004 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0004 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ST-0004 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0004 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 ST-0004 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0004 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ST-0004 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0004 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ST-0004 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0004 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0005 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0005 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$195 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $167.61 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0005 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0005 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$195 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $167.61 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0005 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0005 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$195 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $167.61 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Walgreens from UHC IL-0005 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0005 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$195 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $167.61 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0005 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0005 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$195 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $167.61 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0005 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0005 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$195 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $167.61 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0005 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0005 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$195 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $167.61 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0005 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0005 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$195 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $167.61 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0005 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0005 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$195 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $167.61 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Walgreens from UHC IL-0005 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0005 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$195 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $167.61 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0005 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0005 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$195 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $167.61 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0005 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0005 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$195 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $167.61 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0005 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0005 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$195 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $167.61 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0005 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0005 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$195 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $167.61 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $163.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Walgreens from UHC ST-0002 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC ST-0002 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $160.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC ST-0002 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC ST-0002 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $160.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC ST-0002 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC ST-0002 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $160.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC ST-0002 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC ST-0002 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $160.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC ST-0002 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC ST-0002 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $160.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC ST-0002 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC ST-0002 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $160.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Walgreens from UHC ST-0002 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC ST-0002 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $160.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC ST-0002 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC ST-0002 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $160.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC ST-0002 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC ST-0002 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $160.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC ST-0002 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC ST-0002 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $160.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC ST-0002 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC ST-0002 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $160.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC ST-0002 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC ST-0002 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $160.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Walgreens from UHC ST-0002 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC ST-0002 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $160.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC ST-0002 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC ST-0002 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $160.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC ST-0002 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC ST-0002 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $160.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC ST-0002 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC ST-0002 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $160.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC ST-0002 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC ST-0002 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $160.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC ST-0002 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC ST-0002 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $160.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Walgreens from UHC ST-0002 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC ST-0002 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $160.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage Walgreens from UHC ST-0002 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage Walgreens from UHC ST-0002 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $160.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $692.86 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $697.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $397.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $697.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $697.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $697.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $697.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $697.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $697.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $697.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $697.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $697.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $697.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $697.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $697.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $697.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $697.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $697.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $697.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $697.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $697.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $697.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $697.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $697.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $697.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $697.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $697.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $697.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $697.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $697.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $697.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $697.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $697.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $697.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $697.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $697.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $697.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $697.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $697.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $697.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $697.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $697.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $397.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $697.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $697.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $397.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $697.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $397.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $697.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $397.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $697.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $397.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $697.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $397.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $697.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $397.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $697.04 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $397.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic Plus (HMO-POS)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic Plus (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $397.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Basic Plus (HMO-POS)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic Plus (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $397.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic Plus (HMO-POS)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic Plus (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $397.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic Plus (HMO-POS)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic Plus (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $397.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic Plus (HMO-POS)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic Plus (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $397.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic Plus (HMO-POS)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic Plus (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $397.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic Plus (HMO-POS)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic Plus (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $397.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Basic Plus (HMO-POS)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic Plus (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $397.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Basic Plus (HMO-POS)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Basic Plus (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $397.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Classic (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Classic (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $403.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Classic (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Classic (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $403.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Classic (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Classic (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $403.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Classic (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Classic (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $403.65 |
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 |
Blue Cross Medicare Advantage Classic (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Classic (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $403.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Classic (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Classic (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $403.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Classic (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Classic (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $403.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Classic (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Classic (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $403.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Classic (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Classic (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $403.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Classic (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Classic (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $507.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Classic (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Classic (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $507.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Classic (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Classic (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $507.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Classic (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Classic (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $507.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Classic (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Classic (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $507.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Classic (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Classic (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $507.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Classic (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Classic (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $507.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Classic (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Classic (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $507.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Classic (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Classic (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $507.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Classic (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Classic (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $507.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Classic (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Classic (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $507.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Classic (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Classic (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $507.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Classic (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Classic (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $507.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Classic (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Classic (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $507.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Classic (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Classic (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $507.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Classic (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Classic (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $507.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Classic (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Classic (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $507.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Classic (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Classic (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $507.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Classic (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Classic (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $507.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Classic (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Classic (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $507.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Classic (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Classic (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $507.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Classic (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Classic (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $507.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Classic (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Classic (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $507.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Classic (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Classic (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $507.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Classic (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Classic (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $507.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Classic (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Classic (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $507.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Classic (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Classic (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $507.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Classic (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Classic (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $507.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Classic (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Classic (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $507.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Classic (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Classic (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $507.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Classic (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Classic (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $507.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Dental Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Dental Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Elite (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Elite (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $389.81 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Elite (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Elite (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $389.81 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Elite (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Elite (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $389.81 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Essential (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Essential (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $609.71 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Health Choice (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Health Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Saver Plus (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Saver Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $856.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Saver Plus (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Saver Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $856.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Saver Plus (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Saver Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $856.65 |
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 |
Blue Cross Medicare Advantage Saver Plus (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Saver Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $856.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Saver Plus (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Saver Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $856.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Saver Plus (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Saver Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $856.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Saver Plus (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Saver Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $856.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Saver Plus (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Saver Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $856.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Saver Plus (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Saver Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $856.65 |
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 |
Blue Cross Medicare Advantage Saver Plus (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Saver Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $856.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Saver Plus (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Saver Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $856.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Saver Plus (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Saver Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $856.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Saver Plus (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Saver Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $856.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Saver Plus (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Saver Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $856.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Saver Plus (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Saver Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $856.65 |
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 |
Blue Cross Medicare Advantage Saver Plus (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Saver Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $856.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Saver Plus (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Saver Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $856.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Saver Plus (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Saver Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $856.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Saver Plus (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Saver Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $856.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Saver Plus (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Saver Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $856.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Saver Plus (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Saver Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $856.65 |
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 |
Blue Cross Medicare Advantage Saver Plus (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Saver Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $856.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Saver Plus (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Saver Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $856.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Saver Plus (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Saver Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $856.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Saver Plus (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Saver Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $856.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Saver Plus (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Saver Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $856.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Saver Plus (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Saver Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $856.65 |
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 |
Blue Cross Medicare Advantage Saver Plus (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Saver Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $856.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Saver Plus (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Saver Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $856.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Saver Plus (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Saver Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $856.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Saver Plus (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Saver Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $856.65 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Secure (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Secure (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $397.10 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Secure (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Secure (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $397.10 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Secure (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Secure (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $397.10 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Secure (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Secure (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $397.10 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Secure (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Secure (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $397.10 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Secure (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Secure (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $397.10 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Secure (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Secure (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $397.10 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Value (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $555.99 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Value (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $555.99 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Value (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $555.99 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Value (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $555.99 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Value (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $555.99 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Value (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $555.99 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Value (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $555.99 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Value (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $555.99 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Value (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $555.99 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Value (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $555.99 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Value (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $555.99 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Value (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $555.99 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Value (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $555.99 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Value (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $555.99 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Value (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $555.99 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Value (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $555.99 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Value (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $555.99 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Value (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $555.99 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Value (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $555.99 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Value (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $555.99 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Value (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $555.99 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Value (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $555.99 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Value (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $555.99 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Value (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $555.99 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Value (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $555.99 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Value (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $555.99 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Value (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $555.99 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Value (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $555.99 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Value (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $555.99 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Value (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $555.99 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Value (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $555.99 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Value (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $555.99 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Value (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $555.99 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Value (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $555.99 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Value (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $555.99 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Value (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $555.99 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Value (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $555.99 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Value (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $555.99 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Value (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $555.99 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Value (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $555.99 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Value (HMO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $555.99 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Medicare Advantage (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Blue Medicare Advantage (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:270 /30Days | $419.91 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
![Email Prescription and/or Health Benefit details for Cigna Preferred Medicare (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $525.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
![Email Prescription and/or Health Benefit details for Cigna Preferred Medicare (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $525.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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)
![Email Prescription and/or Health Benefit details for Cigna Preferred Medicare (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $525.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
![Email Prescription and/or Health Benefit details for Cigna Preferred Medicare (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $837.67 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
![Email Prescription and/or Health Benefit details for Cigna Preferred Medicare (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $837.67 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
![Email Prescription and/or Health Benefit details for Cigna Preferred Medicare (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $837.67 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
![Email Prescription and/or Health Benefit details for Cigna Preferred Medicare (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $837.67 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
![Email Prescription and/or Health Benefit details for Cigna Preferred Medicare (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $837.67 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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)
![Email Prescription and/or Health Benefit details for Cigna Preferred Medicare (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $500.64 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
![Email Prescription and/or Health Benefit details for Cigna Preferred Medicare (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $500.64 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
![Email Prescription and/or Health Benefit details for Cigna Preferred Medicare (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $500.64 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
![Email Prescription and/or Health Benefit details for Cigna Preferred Medicare (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $500.64 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
![Email Prescription and/or Health Benefit details for Cigna Preferred Medicare (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $500.64 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
![Email Prescription and/or Health Benefit details for Cigna Preferred Medicare (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $500.64 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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)
![Email Prescription and/or Health Benefit details for Cigna Preferred Medicare (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $500.64 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Medicare (HMO)
![Email Prescription and/or Health Benefit details for Cigna Preferred Medicare (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $500.64 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Savings Medicare (HMO)
![Email Prescription and/or Health Benefit details for Cigna Preferred Savings Medicare (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $500.64 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Savings Medicare (HMO)
![Email Prescription and/or Health Benefit details for Cigna Preferred Savings Medicare (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $500.64 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Savings Medicare (HMO)
![Email Prescription and/or Health Benefit details for Cigna Preferred Savings Medicare (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $500.64 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Savings Medicare (HMO)
![Email Prescription and/or Health Benefit details for Cigna Preferred Savings Medicare (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $500.64 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Savings Medicare (HMO)
![Email Prescription and/or Health Benefit details for Cigna Preferred Savings Medicare (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $500.64 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Savings Medicare (HMO)
![Email Prescription and/or Health Benefit details for Cigna Preferred Savings Medicare (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $500.64 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Savings Medicare (HMO)
![Email Prescription and/or Health Benefit details for Cigna Preferred Savings Medicare (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $500.64 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Preferred Savings Medicare (HMO)
![Email Prescription and/or Health Benefit details for Cigna Preferred Savings Medicare (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $500.64 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Premier Medicare (HMO-POS)
![Email Prescription and/or Health Benefit details for Cigna Premier Medicare (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $500.92 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Premier Medicare (HMO-POS)
![Email Prescription and/or Health Benefit details for Cigna Premier Medicare (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $500.92 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Premier Medicare (HMO-POS)
![Email Prescription and/or Health Benefit details for Cigna Premier Medicare (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $500.92 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Premier Medicare (HMO-POS)
![Email Prescription and/or Health Benefit details for Cigna Premier Medicare (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $500.92 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Premier Medicare (HMO-POS)
![Email Prescription and/or Health Benefit details for Cigna Premier Medicare (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $500.92 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna Premier Medicare (HMO-POS)
![Email Prescription and/or Health Benefit details for Cigna Premier Medicare (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $500.92 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Medicare (PPO)
![Email Prescription and/or Health Benefit details for Cigna True Choice Medicare (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $820.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Medicare (PPO)
![Email Prescription and/or Health Benefit details for Cigna True Choice Medicare (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $820.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Medicare (PPO)
![Email Prescription and/or Health Benefit details for Cigna True Choice Medicare (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $820.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Medicare (PPO)
![Email Prescription and/or Health Benefit details for Cigna True Choice Medicare (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $820.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Medicare (PPO)
![Email Prescription and/or Health Benefit details for Cigna True Choice Medicare (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $500.64 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Medicare (PPO)
![Email Prescription and/or Health Benefit details for Cigna True Choice Medicare (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $500.64 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Medicare (PPO)
![Email Prescription and/or Health Benefit details for Cigna True Choice Medicare (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $500.64 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Medicare (PPO)
![Email Prescription and/or Health Benefit details for Cigna True Choice Medicare (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $500.64 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Medicare (PPO)
![Email Prescription and/or Health Benefit details for Cigna True Choice Medicare (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $500.64 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Medicare (PPO)
![Email Prescription and/or Health Benefit details for Cigna True Choice Medicare (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $500.64 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Medicare (PPO)
![Email Prescription and/or Health Benefit details for Cigna True Choice Medicare (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $500.64 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Medicare (PPO)
![Email Prescription and/or Health Benefit details for Cigna True Choice Medicare (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $500.64 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Medicare (PPO)
![Email Prescription and/or Health Benefit details for Cigna True Choice Medicare (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $525.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Medicare (PPO)
![Email Prescription and/or Health Benefit details for Cigna True Choice Medicare (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $525.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Medicare (PPO)
![Email Prescription and/or Health Benefit details for Cigna True Choice Medicare (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $525.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Medicare (PPO)
![Email Prescription and/or Health Benefit details for Cigna True Choice Medicare (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $837.67 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Medicare (PPO)
![Email Prescription and/or Health Benefit details for Cigna True Choice Medicare (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $837.67 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Medicare (PPO)
![Email Prescription and/or Health Benefit details for Cigna True Choice Medicare (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $837.67 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Medicare (PPO)
![Email Prescription and/or Health Benefit details for Cigna True Choice Medicare (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $837.67 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Medicare (PPO)
![Email Prescription and/or Health Benefit details for Cigna True Choice Medicare (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $837.67 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Medicare (PPO)
![Email Prescription and/or Health Benefit details for Cigna True Choice Medicare (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $820.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Medicare (PPO)
![Email Prescription and/or Health Benefit details for Cigna True Choice Medicare (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $820.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Medicare (PPO)
![Email Prescription and/or Health Benefit details for Cigna True Choice Medicare (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $820.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Medicare (PPO)
![Email Prescription and/or Health Benefit details for Cigna True Choice Medicare (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $820.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Medicare (PPO)
![Email Prescription and/or Health Benefit details for Cigna True Choice Medicare (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $820.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Medicare (PPO)
![Email Prescription and/or Health Benefit details for Cigna True Choice Medicare (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $820.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Medicare (PPO)
![Email Prescription and/or Health Benefit details for Cigna True Choice Medicare (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $820.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Medicare (PPO)
![Email Prescription and/or Health Benefit details for Cigna True Choice Medicare (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $820.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
![Email Prescription and/or Health Benefit details for Cigna True Choice Savings Medicare (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $820.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
![Email Prescription and/or Health Benefit details for Cigna True Choice Savings Medicare (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $820.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
![Email Prescription and/or Health Benefit details for Cigna True Choice Savings Medicare (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $820.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
![Email Prescription and/or Health Benefit details for Cigna True Choice Savings Medicare (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $820.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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)
![Email Prescription and/or Health Benefit details for Cigna True Choice Savings Medicare (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $820.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
![Email Prescription and/or Health Benefit details for Cigna True Choice Savings Medicare (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $820.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
![Email Prescription and/or Health Benefit details for Cigna True Choice Savings Medicare (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $820.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
![Email Prescription and/or Health Benefit details for Cigna True Choice Savings Medicare (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $820.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
![Email Prescription and/or Health Benefit details for Cigna True Choice Savings Medicare (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $820.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
![Email Prescription and/or Health Benefit details for Cigna True Choice Savings Medicare (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $820.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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)
![Email Prescription and/or Health Benefit details for Cigna True Choice Savings Medicare (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $820.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
![Email Prescription and/or Health Benefit details for Cigna True Choice Savings Medicare (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $820.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
![Email Prescription and/or Health Benefit details for Cigna True Choice Savings Medicare (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $525.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
![Email Prescription and/or Health Benefit details for Cigna True Choice Savings Medicare (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $525.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
![Email Prescription and/or Health Benefit details for Cigna True Choice Savings Medicare (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $525.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
![Email Prescription and/or Health Benefit details for Cigna True Choice Savings Medicare (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $500.64 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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)
![Email Prescription and/or Health Benefit details for Cigna True Choice Savings Medicare (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $500.64 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
![Email Prescription and/or Health Benefit details for Cigna True Choice Savings Medicare (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $500.64 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
![Email Prescription and/or Health Benefit details for Cigna True Choice Savings Medicare (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $500.64 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
![Email Prescription and/or Health Benefit details for Cigna True Choice Savings Medicare (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $500.64 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
![Email Prescription and/or Health Benefit details for Cigna True Choice Savings Medicare (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $500.64 |
Browse Plan Formulary all covered insulin pay $35 or less |
Cigna True Choice Savings Medicare (PPO)
![Email Prescription and/or Health Benefit details for Cigna True Choice Savings Medicare (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $500.64 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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)
![Email Prescription and/or Health Benefit details for Cigna True Choice Savings Medicare (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:510 /30Days | $500.64 |
Browse Plan Formulary all covered insulin pay $35 or less |
Clear Spring Health Community Advantage Plan (HMO)
![Email Prescription and/or Health Benefit details for Clear Spring Health Community Advantage Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$95.00 | $237.50 | None | $615.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
Clear Spring Health Community Advantage Plan (HMO)
![Email Prescription and/or Health Benefit details for Clear Spring Health Community Advantage Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$95.00 | $237.50 | None | $615.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
Clear Spring Health Community Advantage Plan (HMO)
![Email Prescription and/or Health Benefit details for Clear Spring Health Community Advantage Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$95.00 | $237.50 | None | $615.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
Clear Spring Health Community Advantage Plan (HMO)
![Email Prescription and/or Health Benefit details for Clear Spring Health Community Advantage Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$95.00 | $237.50 | None | $615.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
Clear Spring Health Community Advantage Plan (HMO)
![Email Prescription and/or Health Benefit details for Clear Spring Health Community Advantage Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$95.00 | $237.50 | None | $615.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Clear Spring Health Community Advantage Plan (HMO)
![Email Prescription and/or Health Benefit details for Clear Spring Health Community Advantage Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$95.00 | $237.50 | None | $615.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
Clear Spring Health Community Advantage Plan (HMO)
![Email Prescription and/or Health Benefit details for Clear Spring Health Community Advantage Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$95.00 | $237.50 | None | $615.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
Clear Spring Health Community Advantage Plan (HMO)
![Email Prescription and/or Health Benefit details for Clear Spring Health Community Advantage Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$95.00 | $237.50 | None | $615.33 |
Browse Plan Formulary all covered insulin pay $35 or less |
Clear Spring Health Essential (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Clear Spring Health Essential (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$95.00 | $237.50 | None | $613.85 |
Browse Plan Formulary all covered insulin pay $35 or less |
Clear Spring Health Essential (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Clear Spring Health Essential (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$95.00 | $237.50 | None | $613.85 |
Browse Plan Formulary all covered insulin pay $35 or less |
Clear Spring Health Essential (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Clear Spring Health Essential (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$95.00 | $237.50 | None | $613.85 |
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 |
Clear Spring Health Essential (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Clear Spring Health Essential (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$95.00 | $237.50 | None | $613.85 |
Browse Plan Formulary all covered insulin pay $35 or less |
Clear Spring Health Essential (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Clear Spring Health Essential (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$95.00 | $237.50 | None | $613.85 |
Browse Plan Formulary all covered insulin pay $35 or less |
Clear Spring Health Essential (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Clear Spring Health Essential (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$95.00 | $237.50 | None | $613.85 |
Browse Plan Formulary all covered insulin pay $35 or less |
Clear Spring Health Essential (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Clear Spring Health Essential (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$95.00 | $237.50 | None | $613.85 |
Browse Plan Formulary all covered insulin pay $35 or less |
Clear Spring Health Essential (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Clear Spring Health Essential (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$95.00 | $237.50 | None | $730.96 |
Browse Plan Formulary all covered insulin pay $35 or less |
Clear Spring Health Essential (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Clear Spring Health Essential (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$95.00 | $237.50 | None | $730.96 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Clear Spring Health Essential (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Clear Spring Health Essential (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$95.00 | $237.50 | None | $730.96 |
Browse Plan Formulary all covered insulin pay $35 or less |
Clear Spring Health Essential (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Clear Spring Health Essential (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$95.00 | $237.50 | None | $730.96 |
Browse Plan Formulary all covered insulin pay $35 or less |
Clear Spring Health Essential (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Clear Spring Health Essential (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$95.00 | $237.50 | None | $730.96 |
Browse Plan Formulary all covered insulin pay $35 or less |
Clear Spring Health Essential (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Clear Spring Health Essential (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$95.00 | $237.50 | None | $730.96 |
Browse Plan Formulary all covered insulin pay $35 or less |
Clear Spring Health Essential (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Clear Spring Health Essential (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$95.00 | $237.50 | None | $730.96 |
Browse Plan Formulary all covered insulin pay $35 or less |
Clear Spring Health Essential (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Clear Spring Health Essential (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$95.00 | $237.50 | None | $730.96 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Clear Spring Health Essential (HMO)
![Email Prescription and/or Health Benefit details for Clear Spring Health Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | None | $730.96 |
Browse Plan Formulary all covered insulin pay $35 or less |
Clear Spring Health Essential (HMO)
![Email Prescription and/or Health Benefit details for Clear Spring Health Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | None | $730.96 |
Browse Plan Formulary all covered insulin pay $35 or less |
Clear Spring Health Essential (HMO)
![Email Prescription and/or Health Benefit details for Clear Spring Health Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | None | $730.96 |
Browse Plan Formulary all covered insulin pay $35 or less |
Clear Spring Health Essential (HMO)
![Email Prescription and/or Health Benefit details for Clear Spring Health Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | None | $730.96 |
Browse Plan Formulary all covered insulin pay $35 or less |
Clear Spring Health Essential (HMO)
![Email Prescription and/or Health Benefit details for Clear Spring Health Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | None | $730.96 |
Browse Plan Formulary all covered insulin pay $35 or less |
Clear Spring Health Essential (HMO)
![Email Prescription and/or Health Benefit details for Clear Spring Health Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | None | $730.96 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Clear Spring Health Essential (HMO)
![Email Prescription and/or Health Benefit details for Clear Spring Health Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | None | $730.96 |
Browse Plan Formulary all covered insulin pay $35 or less |
Clear Spring Health Essential (HMO)
![Email Prescription and/or Health Benefit details for Clear Spring Health Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | None | $730.96 |
Browse Plan Formulary all covered insulin pay $35 or less |
Clear Spring Health Essential (HMO)
![Email Prescription and/or Health Benefit details for Clear Spring Health Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | None | $613.85 |
Browse Plan Formulary all covered insulin pay $35 or less |
Clear Spring Health Essential (HMO)
![Email Prescription and/or Health Benefit details for Clear Spring Health Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | None | $613.85 |
Browse Plan Formulary all covered insulin pay $35 or less |
Clear Spring Health Essential (HMO)
![Email Prescription and/or Health Benefit details for Clear Spring Health Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | None | $613.85 |
Browse Plan Formulary all covered insulin pay $35 or less |
Clear Spring Health Essential (HMO)
![Email Prescription and/or Health Benefit details for Clear Spring Health Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | None | $613.85 |
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 |
Clear Spring Health Essential (HMO)
![Email Prescription and/or Health Benefit details for Clear Spring Health Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | None | $613.85 |
Browse Plan Formulary all covered insulin pay $35 or less |
Clear Spring Health Essential (HMO)
![Email Prescription and/or Health Benefit details for Clear Spring Health Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | None | $613.85 |
Browse Plan Formulary all covered insulin pay $35 or less |
Clear Spring Health Essential (HMO)
![Email Prescription and/or Health Benefit details for Clear Spring Health Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$95.00 | $285.00 | None | $613.85 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CHOICE Illinois (PPO)
![Email Prescription and/or Health Benefit details for Devoted CHOICE Illinois (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$5.00 | $12.50 | Q:540 /30Days | $95.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CHOICE Illinois (PPO)
![Email Prescription and/or Health Benefit details for Devoted CHOICE Illinois (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$5.00 | $12.50 | Q:540 /30Days | $95.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CHOICE Illinois (PPO)
![Email Prescription and/or Health Benefit details for Devoted CHOICE Illinois (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$5.00 | $12.50 | Q:540 /30Days | $95.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Illinois (PPO)
![Email Prescription and/or Health Benefit details for Devoted CHOICE Illinois (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$5.00 | $12.50 | Q:540 /30Days | $95.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CHOICE Illinois (PPO)
![Email Prescription and/or Health Benefit details for Devoted CHOICE Illinois (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$5.00 | $12.50 | Q:540 /30Days | $95.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CHOICE Illinois (PPO)
![Email Prescription and/or Health Benefit details for Devoted CHOICE Illinois (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$5.00 | $12.50 | Q:540 /30Days | $95.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CHOICE Illinois (PPO)
![Email Prescription and/or Health Benefit details for Devoted CHOICE Illinois (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$5.00 | $12.50 | Q:540 /30Days | $95.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CHOICE Illinois (PPO)
![Email Prescription and/or Health Benefit details for Devoted CHOICE Illinois (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$5.00 | $12.50 | Q:540 /30Days | $95.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CORE Illinois (HMO)
![Email Prescription and/or Health Benefit details for Devoted CORE Illinois (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$0.00 | $0.00 | Q:540 /30Days | $95.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Illinois (HMO)
![Email Prescription and/or Health Benefit details for Devoted CORE Illinois (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$0.00 | $0.00 | Q:540 /30Days | $95.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CORE Illinois (HMO)
![Email Prescription and/or Health Benefit details for Devoted CORE Illinois (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$0.00 | $0.00 | Q:540 /30Days | $95.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CORE Illinois (HMO)
![Email Prescription and/or Health Benefit details for Devoted CORE Illinois (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$0.00 | $0.00 | Q:540 /30Days | $95.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CORE Illinois (HMO)
![Email Prescription and/or Health Benefit details for Devoted CORE Illinois (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$0.00 | $0.00 | Q:540 /30Days | $95.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CORE Illinois (HMO)
![Email Prescription and/or Health Benefit details for Devoted CORE Illinois (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$0.00 | $0.00 | Q:540 /30Days | $95.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted CORE Illinois (HMO)
![Email Prescription and/or Health Benefit details for Devoted CORE Illinois (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$0.00 | $0.00 | Q:540 /30Days | $95.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Illinois (HMO)
![Email Prescription and/or Health Benefit details for Devoted CORE Illinois (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$0.00 | $0.00 | Q:540 /30Days | $95.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted GIVEBACK Illinois (HMO)
![Email Prescription and/or Health Benefit details for Devoted GIVEBACK Illinois (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$10.00 | $25.00 | Q:540 /30Days | $95.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted GIVEBACK Illinois (HMO)
![Email Prescription and/or Health Benefit details for Devoted GIVEBACK Illinois (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$10.00 | $25.00 | Q:540 /30Days | $95.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted GIVEBACK Illinois (HMO)
![Email Prescription and/or Health Benefit details for Devoted GIVEBACK Illinois (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$10.00 | $25.00 | Q:540 /30Days | $95.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted GIVEBACK Illinois (HMO)
![Email Prescription and/or Health Benefit details for Devoted GIVEBACK Illinois (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$10.00 | $25.00 | Q:540 /30Days | $95.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted GIVEBACK Illinois (HMO)
![Email Prescription and/or Health Benefit details for Devoted GIVEBACK Illinois (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$10.00 | $25.00 | Q:540 /30Days | $95.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Illinois (HMO)
![Email Prescription and/or Health Benefit details for Devoted GIVEBACK Illinois (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$10.00 | $25.00 | Q:540 /30Days | $95.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted GIVEBACK Illinois (HMO)
![Email Prescription and/or Health Benefit details for Devoted GIVEBACK Illinois (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$10.00 | $25.00 | Q:540 /30Days | $95.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Devoted GIVEBACK Illinois (HMO)
![Email Prescription and/or Health Benefit details for Devoted GIVEBACK Illinois (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$10.00 | $25.00 | Q:540 /30Days | $95.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Essence Advantage (HMO)
![Email Prescription and/or Health Benefit details for Essence Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$0.00 | $0.00 | None | $436.18 |
Browse Plan Formulary all covered insulin pay $35 or less |
Essence Advantage (HMO)
![Email Prescription and/or Health Benefit details for Essence Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$0.00 | $0.00 | None | $436.18 |
Browse Plan Formulary all covered insulin pay $35 or less |
Essence Advantage (HMO)
![Email Prescription and/or Health Benefit details for Essence Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$0.00 | $0.00 | None | $436.18 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Essence Advantage (HMO)
![Email Prescription and/or Health Benefit details for Essence Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$0.00 | $0.00 | None | $436.18 |
Browse Plan Formulary all covered insulin pay $35 or less |
Essence Advantage (HMO)
![Email Prescription and/or Health Benefit details for Essence Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$0.00 | $0.00 | None | $436.18 |
Browse Plan Formulary all covered insulin pay $35 or less |
Essence Advantage (HMO)
![Email Prescription and/or Health Benefit details for Essence Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$0.00 | $0.00 | None | $436.18 |
Browse Plan Formulary all covered insulin pay $35 or less |
Essence Advantage (HMO)
![Email Prescription and/or Health Benefit details for Essence Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$0.00 | $0.00 | None | $436.18 |
Browse Plan Formulary all covered insulin pay $35 or less |
Essence Advantage Choice (PPO)
![Email Prescription and/or Health Benefit details for Essence Advantage Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$0.00 | $0.00 | None | $436.18 |
Browse Plan Formulary all covered insulin pay $35 or less |
Essence Advantage Choice (PPO)
![Email Prescription and/or Health Benefit details for Essence Advantage Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$0.00 | $0.00 | None | $436.18 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Essence Advantage Choice (PPO)
![Email Prescription and/or Health Benefit details for Essence Advantage Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$0.00 | $0.00 | None | $436.18 |
Browse Plan Formulary all covered insulin pay $35 or less |
Essence Advantage Choice (PPO)
![Email Prescription and/or Health Benefit details for Essence Advantage Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$0.00 | $0.00 | None | $436.18 |
Browse Plan Formulary all covered insulin pay $35 or less |
Essence Advantage Choice (PPO)
![Email Prescription and/or Health Benefit details for Essence Advantage Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$0.00 | $0.00 | None | $436.18 |
Browse Plan Formulary all covered insulin pay $35 or less |
Essence Advantage Choice (PPO)
![Email Prescription and/or Health Benefit details for Essence Advantage Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$0.00 | $0.00 | None | $436.18 |
Browse Plan Formulary all covered insulin pay $35 or less |
Essence Advantage Choice (PPO)
![Email Prescription and/or Health Benefit details for Essence Advantage Choice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$0.00 | $0.00 | None | $436.18 |
Browse Plan Formulary all covered insulin pay $35 or less |
Essence Advantage Select (HMO)
![Email Prescription and/or Health Benefit details for Essence Advantage Select (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$0.00 | $0.00 | None | $436.18 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Essence Advantage Select (HMO)
![Email Prescription and/or Health Benefit details for Essence Advantage Select (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$0.00 | $0.00 | None | $436.18 |
Browse Plan Formulary all covered insulin pay $35 or less |
Essence Advantage Select (HMO)
![Email Prescription and/or Health Benefit details for Essence Advantage Select (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$0.00 | $0.00 | None | $436.18 |
Browse Plan Formulary all covered insulin pay $35 or less |
Essence Advantage Select (HMO)
![Email Prescription and/or Health Benefit details for Essence Advantage Select (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$0.00 | $0.00 | None | $436.18 |
Browse Plan Formulary all covered insulin pay $35 or less |
Essence Advantage Select (HMO)
![Email Prescription and/or Health Benefit details for Essence Advantage Select (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$0.00 | $0.00 | None | $436.18 |
Browse Plan Formulary all covered insulin pay $35 or less |
Essence Advantage Select (HMO)
![Email Prescription and/or Health Benefit details for Essence Advantage Select (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$0.00 | $0.00 | None | $436.18 |
Browse Plan Formulary all covered insulin pay $35 or less |
Essence Advantage Select (HMO)
![Email Prescription and/or Health Benefit details for Essence Advantage Select (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$0.00 | $0.00 | None | $436.18 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Community HMO Diabetes and Heart (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Humana Community HMO Diabetes and Heart (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$99.00 | $287.00 | Q:540 /30Days | $154.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Community HMO Diabetes and Heart (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Humana Community HMO Diabetes and Heart (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$99.00 | $287.00 | Q:540 /30Days | $154.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Community HMO Diabetes and Heart (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Humana Community HMO Diabetes and Heart (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$99.00 | $287.00 | Q:540 /30Days | $154.40 |
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 |
Humana Community Select (HMO)
![Email Prescription and/or Health Benefit details for Humana Community Select (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $159.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Community Select (HMO)
![Email Prescription and/or Health Benefit details for Humana Community Select (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $159.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Community Select (HMO)
![Email Prescription and/or Health Benefit details for Humana Community Select (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $159.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H0028-014 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H0028-014 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$99.00 | $287.00 | Q:540 /30Days | $153.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H0028-014 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H0028-014 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$99.00 | $287.00 | Q:540 /30Days | $153.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H0028-014 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H0028-014 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$99.00 | $287.00 | Q:540 /30Days | $153.80 |
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 |
Humana Gold Plus H0028-014 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H0028-014 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$99.00 | $287.00 | Q:540 /30Days | $153.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H0028-014 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H0028-014 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$99.00 | $287.00 | Q:540 /30Days | $153.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H0028-014 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H0028-014 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$99.00 | $287.00 | Q:540 /30Days | $153.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H0028-014 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H0028-014 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$99.00 | $287.00 | Q:540 /30Days | $153.80 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H1468-007 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H1468-007 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.94 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H1468-007 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H1468-007 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.94 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 H1468-007 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H1468-007 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.94 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H1468-007 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H1468-007 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.94 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H1468-007 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H1468-007 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.94 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H1468-007 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H1468-007 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.94 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H1468-007 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H1468-007 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.94 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H1468-007 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H1468-007 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.94 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 H1468-007 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H1468-007 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.94 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H1468-007 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H1468-007 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.94 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H1468-007 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H1468-007 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.94 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H1468-007 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H1468-007 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.94 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H1468-007 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H1468-007 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.94 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H1468-007 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H1468-007 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.94 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 H1468-007 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H1468-007 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.94 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H1468-013 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H1468-013 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $154.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H1468-013 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H1468-013 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $154.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H1468-013 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H1468-013 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $154.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H1468-013 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H1468-013 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $154.30 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H1468-013 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H1468-013 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $154.30 |
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 |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
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 |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
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 |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
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 |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
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 |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
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 |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
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 |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
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 |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
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 |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
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 |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
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 |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
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 |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
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 |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
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 |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
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 |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
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 |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
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 |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $155.40 |
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 |
HumanaChoice H5216-215 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-215 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $163.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-215 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-215 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $163.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-215 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-215 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $163.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-215 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-215 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $163.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-215 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-215 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $163.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-215 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-215 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $163.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 H5216-215 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-215 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $163.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-215 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-215 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $163.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-215 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-215 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $163.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-215 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-215 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $163.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-215 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-215 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $163.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-215 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-215 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $163.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 H5216-215 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-215 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $163.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-215 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-215 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $163.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-215 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-215 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $163.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-215 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-215 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $163.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-215 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-215 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $163.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-215 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-215 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $163.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 H5216-215 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-215 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $163.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-215 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-215 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $163.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-215 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-215 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $163.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-215 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-215 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $163.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-215 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-215 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $163.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-215 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-215 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $163.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 H5216-215 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-215 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $163.48 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-251 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-251 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $154.74 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-251 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-251 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $154.74 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-251 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-251 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $154.74 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-251 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-251 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $154.74 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-251 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-251 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $154.74 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 H5216-251 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-251 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $154.74 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-251 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-251 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $154.74 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-251 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-251 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $154.74 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-251 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-251 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $154.74 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-251 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-251 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $154.74 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-251 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-251 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $154.74 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 H5216-251 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-251 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $154.74 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-251 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-251 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $154.74 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-251 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-251 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $154.74 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-318 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-318 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$99.00 | $287.00 | Q:540 /30Days | $154.50 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-318 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-318 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$99.00 | $287.00 | Q:540 /30Days | $153.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-318 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-318 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$99.00 | $287.00 | Q:540 /30Days | $159.26 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 H5216-318 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-318 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$99.00 | $287.00 | Q:540 /30Days | $154.50 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-318 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-318 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$99.00 | $287.00 | Q:540 /30Days | $153.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-318 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-318 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$99.00 | $287.00 | Q:540 /30Days | $159.26 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-318 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-318 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$99.00 | $287.00 | Q:540 /30Days | $154.50 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-318 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-318 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$99.00 | $287.00 | Q:540 /30Days | $153.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-318 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-318 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$99.00 | $287.00 | Q:540 /30Days | $159.26 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 H5216-318 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-318 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$99.00 | $287.00 | Q:540 /30Days | $154.50 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-318 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-318 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$99.00 | $287.00 | Q:540 /30Days | $153.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-318 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-318 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$99.00 | $287.00 | Q:540 /30Days | $159.26 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-318 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-318 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$99.00 | $287.00 | Q:540 /30Days | $154.50 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-318 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-318 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$99.00 | $287.00 | Q:540 /30Days | $153.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-318 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-318 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$99.00 | $287.00 | Q:540 /30Days | $159.26 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 H5216-318 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-318 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$99.00 | $287.00 | Q:540 /30Days | $154.50 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-318 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-318 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$99.00 | $287.00 | Q:540 /30Days | $153.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-318 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-318 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$99.00 | $287.00 | Q:540 /30Days | $159.26 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-318 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-318 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$99.00 | $287.00 | Q:540 /30Days | $154.50 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-318 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-318 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$99.00 | $287.00 | Q:540 /30Days | $153.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-318 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-318 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$99.00 | $287.00 | Q:540 /30Days | $159.26 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 H5216-318 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-318 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$99.00 | $287.00 | Q:540 /30Days | $154.50 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-318 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-318 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$99.00 | $287.00 | Q:540 /30Days | $153.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-318 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-318 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$99.00 | $287.00 | Q:540 /30Days | $159.26 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-068 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-068 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.36 |
Browse Plan Formulary all covered insulin pay $35 or less |
Medica Advantage with SSM Value (HMO-POS)
![Email Prescription and/or Health Benefit details for Medica Advantage with SSM Value (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$8.00 | $0.00 | None | $731.82 |
Browse Plan Formulary all covered insulin pay $35 or less |
Medica Advantage with SSM Value (HMO-POS)
![Email Prescription and/or Health Benefit details for Medica Advantage with SSM Value (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$8.00 | $0.00 | None | $731.82 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
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 |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
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 |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
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 |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
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 |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
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 |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
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 |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
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 |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
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 |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
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 |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
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 |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
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 |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
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 |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
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 |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
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 |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
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 |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
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 |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
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 |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Tier 2 |
0% | 0% | Q:540 /30Days | $217.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Dual Options (Medicare-Medicaid Plan)
![Email Prescription and/or Health Benefit details for Molina Dual Options (Medicare-Medicaid Plan)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
1 |
Tier 1 |
0% | 0% | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Choice Care (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare Choice Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$125 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$12.00 | $24.00 | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Molina Medicare Choice Care (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare Choice Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$125 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$12.00 | $24.00 | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Choice Care (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare Choice Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$125 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$12.00 | $24.00 | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Choice Care (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare Choice Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$125 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$12.00 | $24.00 | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Choice Care (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare Choice Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$125 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$12.00 | $24.00 | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Choice Care (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare Choice Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$125 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$12.00 | $24.00 | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Choice Care (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare Choice Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$125 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$12.00 | $24.00 | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Molina Medicare Choice Care (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare Choice Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$125 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$12.00 | $24.00 | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Choice Care (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare Choice Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$125 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$12.00 | $24.00 | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Choice Care (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare Choice Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$125 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$12.00 | $24.00 | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Choice Care (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare Choice Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$125 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$12.00 | $24.00 | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Choice Care (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare Choice Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$125 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$12.00 | $24.00 | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Choice Care (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare Choice Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$125 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$12.00 | $24.00 | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Molina Medicare Choice Care (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare Choice Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$125 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$12.00 | $24.00 | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Choice Care (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare Choice Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$125 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$12.00 | $24.00 | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Choice Care (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare Choice Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$125 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$12.00 | $24.00 | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Choice Care (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare Choice Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$125 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$12.00 | $24.00 | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Choice Care (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare Choice Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$125 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$12.00 | $24.00 | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Choice Care (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare Choice Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$125 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$12.00 | $24.00 | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Molina Medicare Choice Care (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare Choice Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$125 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$12.00 | $24.00 | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Choice Care (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare Choice Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$125 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$12.00 | $24.00 | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Choice Care (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare Choice Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$125 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$12.00 | $24.00 | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Choice Care (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare Choice Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$125 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$12.00 | $24.00 | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Choice Care (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare Choice Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$125 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$12.00 | $24.00 | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Choice Care (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare Choice Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$125 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$12.00 | $24.00 | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Molina Medicare Choice Care (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare Choice Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$125 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$12.00 | $24.00 | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Choice Care (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare Choice Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$125 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$12.00 | $24.00 | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Choice Care (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare Choice Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$125 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$12.00 | $24.00 | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Choice Care (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare Choice Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$125 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$12.00 | $24.00 | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Choice Care (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare Choice Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$125 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$12.00 | $24.00 | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Choice Care (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare Choice Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$125 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$12.00 | $24.00 | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Molina Medicare Choice Care (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare Choice Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$125 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$12.00 | $24.00 | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Choice Care (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare Choice Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$125 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$12.00 | $24.00 | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Choice Care (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare Choice Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$125 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$12.00 | $24.00 | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Choice Care (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare Choice Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$125 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$12.00 | $24.00 | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Choice Care (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare Choice Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$125 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$12.00 | $24.00 | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Choice Care (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare Choice Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$125 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$12.00 | $24.00 | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Molina Medicare Choice Care (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare Choice Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$125 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$12.00 | $24.00 | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Choice Care (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare Choice Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$125 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$12.00 | $24.00 | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Choice Care (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare Choice Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$125 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$12.00 | $24.00 | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Choice Care (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare Choice Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$125 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$12.00 | $24.00 | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Choice Care (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare Choice Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$125 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$12.00 | $24.00 | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Choice Care (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare Choice Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$125 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$12.00 | $24.00 | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Molina Medicare Choice Care (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare Choice Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$125 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$12.00 | $24.00 | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Choice Care (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare Choice Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$125 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$12.00 | $24.00 | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Molina Medicare Choice Care (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare Choice Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$125 |
No additional gap coverage, only the Donut Hole Discount |
2 |
Generic |
$12.00 | $24.00 | Q:540 /30Days | $740.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
OSF with Medica Advantage Select (HMO-POS)
![Email Prescription and/or Health Benefit details for OSF with Medica Advantage Select (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$8.00 | $0.00 | None | $641.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
OSF with Medica Advantage Select (HMO-POS)
![Email Prescription and/or Health Benefit details for OSF with Medica Advantage Select (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$8.00 | $0.00 | None | $641.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
OSF with Medica Advantage Select (HMO-POS)
![Email Prescription and/or Health Benefit details for OSF with Medica Advantage Select (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$8.00 | $0.00 | None | $641.70 |
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 |
OSF with Medica Advantage Select (HMO-POS)
![Email Prescription and/or Health Benefit details for OSF with Medica Advantage Select (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$8.00 | $0.00 | None | $641.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
OSF with Medica Advantage Select (HMO-POS)
![Email Prescription and/or Health Benefit details for OSF with Medica Advantage Select (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$8.00 | $0.00 | None | $641.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
OSF with Medica Advantage Select (HMO-POS)
![Email Prescription and/or Health Benefit details for OSF with Medica Advantage Select (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$8.00 | $0.00 | None | $641.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
OSF with Medica Advantage Select (HMO-POS)
![Email Prescription and/or Health Benefit details for OSF with Medica Advantage Select (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$8.00 | $0.00 | None | $641.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
OSF with Medica Advantage Value (HMO)
![Email Prescription and/or Health Benefit details for OSF with Medica Advantage Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$8.00 | $0.00 | None | $641.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
OSF with Medica Advantage Value (HMO)
![Email Prescription and/or Health Benefit details for OSF with Medica Advantage Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$8.00 | $0.00 | None | $641.70 |
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 |
OSF with Medica Advantage Value (HMO)
![Email Prescription and/or Health Benefit details for OSF with Medica Advantage Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$8.00 | $0.00 | None | $641.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
OSF with Medica Advantage Value (HMO)
![Email Prescription and/or Health Benefit details for OSF with Medica Advantage Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$8.00 | $0.00 | None | $641.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
OSF with Medica Advantage Value (HMO)
![Email Prescription and/or Health Benefit details for OSF with Medica Advantage Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$8.00 | $0.00 | None | $641.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
OSF with Medica Advantage Value (HMO)
![Email Prescription and/or Health Benefit details for OSF with Medica Advantage Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$8.00 | $0.00 | None | $641.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
OSF with Medica Advantage Value (HMO)
![Email Prescription and/or Health Benefit details for OSF with Medica Advantage Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
2 |
Generic |
$8.00 | $0.00 | None | $641.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
UW Health IL Quartz Med Advantage Core D (w/Rx) (HMO)
![Email Prescription and/or Health Benefit details for UW Health IL Quartz Med Advantage Core D (w/Rx) (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$300* |
Yes, but No Gap Coverage for this drug. |
2* |
Generic |
$20.00 | $50.00 | P | $739.17 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UW Health IL Quartz Med Advantage Core D (w/Rx) (HMO)
![Email Prescription and/or Health Benefit details for UW Health IL Quartz Med Advantage Core D (w/Rx) (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$300* |
Yes, but No Gap Coverage for this drug. |
2* |
Generic |
$20.00 | $50.00 | P | $739.17 |
Browse Plan Formulary all covered insulin pay $35 or less |
UW Health IL Quartz Med Advantage Core D (w/Rx) (HMO)
![Email Prescription and/or Health Benefit details for UW Health IL Quartz Med Advantage Core D (w/Rx) (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$300* |
Yes, but No Gap Coverage for this drug. |
2* |
Generic |
$20.00 | $50.00 | P | $739.17 |
Browse Plan Formulary all covered insulin pay $35 or less |
UW Health IL Quartz Med Advantage Core D (w/Rx) (HMO)
![Email Prescription and/or Health Benefit details for UW Health IL Quartz Med Advantage Core D (w/Rx) (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$300* |
Yes, but No Gap Coverage for this drug. |
2* |
Generic |
$20.00 | $50.00 | P | $739.17 |
Browse Plan Formulary all covered insulin pay $35 or less |
UW Health IL Quartz Med Advantage Core D (w/Rx) (HMO)
![Email Prescription and/or Health Benefit details for UW Health IL Quartz Med Advantage Core D (w/Rx) (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$300* |
Yes, but No Gap Coverage for this drug. |
2* |
Generic |
$20.00 | $50.00 | P | $739.17 |
Browse Plan Formulary all covered insulin pay $35 or less |
UW Health IL Quartz Med Advantage Core D (w/Rx) (HMO)
![Email Prescription and/or Health Benefit details for UW Health IL Quartz Med Advantage Core D (w/Rx) (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$300* |
Yes, but No Gap Coverage for this drug. |
2* |
Generic |
$20.00 | $50.00 | P | $739.17 |
Browse Plan Formulary all covered insulin pay $35 or less |
UW Health IL Quartz Med Advantage Core D (w/Rx) (HMO)
![Email Prescription and/or Health Benefit details for UW Health IL Quartz Med Advantage Core D (w/Rx) (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$300* |
Yes, but No Gap Coverage for this drug. |
2* |
Generic |
$20.00 | $50.00 | P | $739.17 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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)
![Email Prescription and/or Health Benefit details for Wellcare Complete - Giveback (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$500 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $361.61 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Complete - Giveback (HMO)
![Email Prescription and/or Health Benefit details for Wellcare Complete - Giveback (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$500 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $361.61 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Complete - Giveback (HMO)
![Email Prescription and/or Health Benefit details for Wellcare Complete - Giveback (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$500 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $361.61 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Complete - Giveback (HMO)
![Email Prescription and/or Health Benefit details for Wellcare Complete - Giveback (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$500 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $361.61 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Complete - Giveback (HMO)
![Email Prescription and/or Health Benefit details for Wellcare Complete - Giveback (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$500 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $361.61 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Giveback Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare Giveback Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO-POS)
![Email Prescription and/or Health Benefit details for Wellcare No Premium (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
45% | 45% | Q:540 /30Days | $358.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO-POS)
![Email Prescription and/or Health Benefit details for Wellcare No Premium (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
45% | 45% | Q:540 /30Days | $358.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO-POS)
![Email Prescription and/or Health Benefit details for Wellcare No Premium (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
45% | 45% | Q:540 /30Days | $358.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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-POS)
![Email Prescription and/or Health Benefit details for Wellcare No Premium (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
45% | 45% | Q:540 /30Days | $358.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO-POS)
![Email Prescription and/or Health Benefit details for Wellcare No Premium (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
45% | 45% | Q:540 /30Days | $358.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO-POS)
![Email Prescription and/or Health Benefit details for Wellcare No Premium (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
45% | 45% | Q:540 /30Days | $358.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO-POS)
![Email Prescription and/or Health Benefit details for Wellcare No Premium (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
45% | 45% | Q:540 /30Days | $358.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO-POS)
![Email Prescription and/or Health Benefit details for Wellcare No Premium (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
45% | 45% | Q:540 /30Days | $358.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium (HMO-POS)
![Email Prescription and/or Health Benefit details for Wellcare No Premium (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
45% | 45% | Q:540 /30Days | $358.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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-POS)
![Email Prescription and/or Health Benefit details for Wellcare No Premium (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
45% | 45% | Q:540 /30Days | $358.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
46% | 46% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Essential Value (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Essential Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Exclusive (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Exclusive (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
49% | 49% | Q:540 /30Days | $361.78 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Exclusive (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Exclusive (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
49% | 49% | Q:540 /30Days | $361.78 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Exclusive (HMO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Exclusive (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
49% | 49% | Q:540 /30Days | $361.78 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Open (PPO)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Open (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
47% | 47% | Q:540 /30Days | $347.68 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Value (HMO-POS)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Value (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $358.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Value (HMO-POS)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Value (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $358.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Value (HMO-POS)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Value (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $358.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Value (HMO-POS)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Value (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $358.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Value (HMO-POS)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Value (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $358.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Value (HMO-POS)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Value (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $358.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Value (HMO-POS)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Value (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $358.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Value (HMO-POS)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Value (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $358.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Value (HMO-POS)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Value (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $358.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare No Premium Value (HMO-POS)
![Email Prescription and/or Health Benefit details for Wellcare No Premium Value (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
50% | 50% | Q:540 /30Days | $358.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Choice IL (HMO)
![Email Prescription and/or Health Benefit details for Zing Choice IL (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $200.00 | Q:540 /30Days | $970.29 |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Choice IL (HMO)
![Email Prescription and/or Health Benefit details for Zing Choice IL (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $200.00 | Q:540 /30Days | $970.29 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Zing Choice IL (HMO)
![Email Prescription and/or Health Benefit details for Zing Choice IL (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $200.00 | Q:540 /30Days | $970.29 |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Choice IL (HMO)
![Email Prescription and/or Health Benefit details for Zing Choice IL (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $200.00 | Q:540 /30Days | $970.29 |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Choice IL (HMO)
![Email Prescription and/or Health Benefit details for Zing Choice IL (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $200.00 | Q:540 /30Days | $970.29 |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Choice IL (HMO)
![Email Prescription and/or Health Benefit details for Zing Choice IL (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $200.00 | Q:540 /30Days | $970.29 |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Elite Diabetes & Heart IL (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Zing Elite Diabetes & Heart IL (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $200.00 | Q:540 /30Days | $786.77 |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Elite Diabetes & Heart IL (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Zing Elite Diabetes & Heart IL (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $200.00 | Q:540 /30Days | $786.77 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Zing Elite Diabetes & Heart IL (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Zing Elite Diabetes & Heart IL (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $200.00 | Q:540 /30Days | $786.77 |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Elite Diabetes & Heart IL (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Zing Elite Diabetes & Heart IL (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $200.00 | Q:540 /30Days | $786.77 |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Elite Select IL (HMO)
![Email Prescription and/or Health Benefit details for Zing Elite Select IL (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$100.00 | $200.00 | Q:540 /30Days | tbd |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Elite Select IL (HMO)
![Email Prescription and/or Health Benefit details for Zing Elite Select IL (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$100.00 | $200.00 | Q:540 /30Days | tbd |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Elite Select IL (HMO)
![Email Prescription and/or Health Benefit details for Zing Elite Select IL (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$100.00 | $200.00 | Q:540 /30Days | tbd |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Elite Select IL (HMO)
![Email Prescription and/or Health Benefit details for Zing Elite Select IL (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$100.00 | $200.00 | Q:540 /30Days | tbd |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Zing ESRD Select IL (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Zing ESRD Select IL (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$100.00 | $200.00 | Q:540 /30Days | tbd |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing ESRD Select IL (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Zing ESRD Select IL (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$100.00 | $200.00 | Q:540 /30Days | tbd |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing ESRD Select IL (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Zing ESRD Select IL (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$100.00 | $200.00 | Q:540 /30Days | tbd |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing ESRD Select IL (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Zing ESRD Select IL (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$100.00 | $200.00 | Q:540 /30Days | tbd |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Essential Wellness Diabetes & Heart IL (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Zing Essential Wellness Diabetes & Heart IL (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $200.00 | Q:540 /30Days | $804.11 |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Essential Wellness Diabetes & Heart IL (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Zing Essential Wellness Diabetes & Heart IL (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $200.00 | Q:540 /30Days | $804.11 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Zing Essential Wellness Diabetes & Heart IL (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Zing Essential Wellness Diabetes & Heart IL (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $200.00 | Q:540 /30Days | $804.11 |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Essential Wellness Diabetes & Heart IL (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Zing Essential Wellness Diabetes & Heart IL (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $200.00 | Q:540 /30Days | $804.11 |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Essential Wellness Diabetes & Heart IL (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Zing Essential Wellness Diabetes & Heart IL (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $200.00 | Q:540 /30Days | $804.11 |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Essential Wellness Diabetes & Heart IL (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Zing Essential Wellness Diabetes & Heart IL (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $200.00 | Q:540 /30Days | $804.11 |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Essential Wellness Diabetes & Heart IL (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Zing Essential Wellness Diabetes & Heart IL (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $200.00 | Q:540 /30Days | $804.11 |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Select Care IL (HMO)
![Email Prescription and/or Health Benefit details for Zing Select Care IL (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$100.00 | $200.00 | Q:540 /30Days | tbd |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Zing Select Care IL (HMO)
![Email Prescription and/or Health Benefit details for Zing Select Care IL (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$100.00 | $200.00 | Q:540 /30Days | tbd |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Select Care IL (HMO)
![Email Prescription and/or Health Benefit details for Zing Select Care IL (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$100.00 | $200.00 | Q:540 /30Days | tbd |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Select Care IL (HMO)
![Email Prescription and/or Health Benefit details for Zing Select Care IL (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$100.00 | $200.00 | Q:540 /30Days | tbd |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Select Care IL (HMO)
![Email Prescription and/or Health Benefit details for Zing Select Care IL (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$100.00 | $200.00 | Q:540 /30Days | tbd |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Select Care IL (HMO)
![Email Prescription and/or Health Benefit details for Zing Select Care IL (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$100.00 | $200.00 | Q:540 /30Days | tbd |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Select Care IL (HMO)
![Email Prescription and/or Health Benefit details for Zing Select Care IL (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$100.00 | $200.00 | Q:540 /30Days | tbd |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Zing Select Care IL (HMO)
![Email Prescription and/or Health Benefit details for Zing Select Care IL (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$100.00 | $200.00 | Q:540 /30Days | tbd |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Select Care IL (HMO)
![Email Prescription and/or Health Benefit details for Zing Select Care IL (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$100.00 | $200.00 | Q:540 /30Days | tbd |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Select Care IL (HMO)
![Email Prescription and/or Health Benefit details for Zing Select Care IL (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$100.00 | $200.00 | Q:540 /30Days | tbd |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Select Care IL (HMO)
![Email Prescription and/or Health Benefit details for Zing Select Care IL (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$100.00 | $200.00 | Q:540 /30Days | tbd |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Select Diabetes & Heart IL (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Zing Select Diabetes & Heart IL (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$100.00 | $200.00 | Q:540 /30Days | tbd |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Select Diabetes & Heart IL (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Zing Select Diabetes & Heart IL (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$100.00 | $200.00 | Q:540 /30Days | tbd |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Zing Select Diabetes & Heart IL (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Zing Select Diabetes & Heart IL (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$100.00 | $200.00 | Q:540 /30Days | tbd |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Select Diabetes & Heart IL (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Zing Select Diabetes & Heart IL (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$100.00 | $200.00 | Q:540 /30Days | tbd |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Select Diabetes & Heart IL (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Zing Select Diabetes & Heart IL (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$100.00 | $200.00 | Q:540 /30Days | tbd |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Select Diabetes & Heart IL (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Zing Select Diabetes & Heart IL (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$100.00 | $200.00 | Q:540 /30Days | tbd |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Select Diabetes & Heart IL (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Zing Select Diabetes & Heart IL (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$100.00 | $200.00 | Q:540 /30Days | tbd |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Select Diabetes & Heart IL (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Zing Select Diabetes & Heart IL (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$100.00 | $200.00 | Q:540 /30Days | tbd |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Zing Select Diabetes & Heart IL (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Zing Select Diabetes & Heart IL (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$100.00 | $200.00 | Q:540 /30Days | tbd |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Select Diabetes & Heart IL (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Zing Select Diabetes & Heart IL (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$100.00 | $200.00 | Q:540 /30Days | tbd |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Select Diabetes & Heart IL (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Zing Select Diabetes & Heart IL (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$100.00 | $200.00 | Q:540 /30Days | tbd |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care ST-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care ST-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $165.21 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care ST-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care ST-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $165.21 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care ST-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care ST-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $165.21 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 ST-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care ST-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $165.21 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care ST-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care ST-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $165.21 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care ST-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care ST-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $165.21 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care ST-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care ST-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $165.21 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care ST-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care ST-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $165.21 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care ST-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care ST-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $165.21 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 ST-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care ST-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $165.21 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care ST-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care ST-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $165.21 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care ST-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care ST-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $165.21 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care ST-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care ST-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $165.21 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care ST-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care ST-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $165.21 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care ST-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care ST-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $165.21 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 ST-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care ST-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $165.21 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care ST-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care ST-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $165.21 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care ST-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care ST-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $165.21 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care ST-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care ST-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $165.21 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care ST-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care ST-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $165.21 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist Compass (HMO)
![Email Prescription and/or Health Benefit details for Wellcare Assist Compass (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
45% | 45% | Q:540 /30Days | $358.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Compass (HMO)
![Email Prescription and/or Health Benefit details for Wellcare Assist Compass (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
45% | 45% | Q:540 /30Days | $358.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist Compass (HMO)
![Email Prescription and/or Health Benefit details for Wellcare Assist Compass (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
45% | 45% | Q:540 /30Days | $358.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist Compass (HMO)
![Email Prescription and/or Health Benefit details for Wellcare Assist Compass (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
45% | 45% | Q:540 /30Days | $358.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist Compass (HMO)
![Email Prescription and/or Health Benefit details for Wellcare Assist Compass (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
45% | 45% | Q:540 /30Days | $358.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist Compass (HMO)
![Email Prescription and/or Health Benefit details for Wellcare Assist Compass (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
45% | 45% | Q:540 /30Days | $358.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist Compass (HMO)
![Email Prescription and/or Health Benefit details for Wellcare Assist Compass (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
45% | 45% | Q:540 /30Days | $358.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Compass (HMO)
![Email Prescription and/or Health Benefit details for Wellcare Assist Compass (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
45% | 45% | Q:540 /30Days | $358.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist Compass (HMO)
![Email Prescription and/or Health Benefit details for Wellcare Assist Compass (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
45% | 45% | Q:540 /30Days | $358.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
Wellcare Assist Compass (HMO)
![Email Prescription and/or Health Benefit details for Wellcare Assist Compass (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
45% | 45% | Q:540 /30Days | $358.73 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Nursing Home Plan IL-F002 (HMO-POS I-SNP)
![Email Prescription and/or Health Benefit details for UHC Nursing Home Plan IL-F002 (HMO-POS I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $170.32 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Nursing Home Plan IL-F002 (HMO-POS I-SNP)
![Email Prescription and/or Health Benefit details for UHC Nursing Home Plan IL-F002 (HMO-POS I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $170.32 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Nursing Home Plan IL-F002 (HMO-POS I-SNP)
![Email Prescription and/or Health Benefit details for UHC Nursing Home Plan IL-F002 (HMO-POS I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $170.32 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IL-F002 (HMO-POS I-SNP)
![Email Prescription and/or Health Benefit details for UHC Nursing Home Plan IL-F002 (HMO-POS I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $170.32 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Nursing Home Plan IL-F002 (HMO-POS I-SNP)
![Email Prescription and/or Health Benefit details for UHC Nursing Home Plan IL-F002 (HMO-POS I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $170.32 |
Browse Plan Formulary all covered insulin pay $35 or less |
Essence Advantage Choice Plus (PPO)
![Email Prescription and/or Health Benefit details for Essence Advantage Choice Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.20 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$0.00 | $0.00 | None | $436.18 |
Browse Plan Formulary all covered insulin pay $35 or less |
Essence Advantage Choice Plus (PPO)
![Email Prescription and/or Health Benefit details for Essence Advantage Choice Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.20 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$0.00 | $0.00 | None | $436.18 |
Browse Plan Formulary all covered insulin pay $35 or less |
Essence Advantage Choice Plus (PPO)
![Email Prescription and/or Health Benefit details for Essence Advantage Choice Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.20 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$0.00 | $0.00 | None | $436.18 |
Browse Plan Formulary all covered insulin pay $35 or less |
Essence Advantage Choice Plus (PPO)
![Email Prescription and/or Health Benefit details for Essence Advantage Choice Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.20 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$0.00 | $0.00 | None | $436.18 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Essence Advantage Choice Plus (PPO)
![Email Prescription and/or Health Benefit details for Essence Advantage Choice Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.20 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$0.00 | $0.00 | None | $436.18 |
Browse Plan Formulary all covered insulin pay $35 or less |
Essence Advantage Choice Plus (PPO)
![Email Prescription and/or Health Benefit details for Essence Advantage Choice Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.20 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$0.00 | $0.00 | None | $436.18 |
Browse Plan Formulary all covered insulin pay $35 or less |
Essence Advantage Choice Plus (PPO)
![Email Prescription and/or Health Benefit details for Essence Advantage Choice Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.20 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$0.00 | $0.00 | None | $436.18 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Complete Care IL-001A (PPO C-SNP)
![Email Prescription and/or Health Benefit details for UHC Complete Care IL-001A (PPO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $172.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IL-0001 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0001 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $170.15 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0001 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0001 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $170.15 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0001 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0001 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $170.15 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0001 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0001 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $170.15 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0001 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0001 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $170.15 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0001 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0001 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $170.15 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IL-0001 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0001 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $170.15 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0001 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0001 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $170.15 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0001 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0001 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $170.15 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0001 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0001 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $170.15 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0001 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0001 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $170.15 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0001 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0001 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $170.15 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IL-0001 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0001 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $170.15 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0001 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0001 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $170.15 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-283 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-283 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $154.74 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-283 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-283 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $154.74 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-283 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-283 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $154.74 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-283 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-283 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $154.74 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 H5216-283 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-283 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $154.74 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-283 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-283 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $154.74 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-283 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-283 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $154.74 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-283 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-283 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $154.74 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-283 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-283 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $154.74 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-283 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-283 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $154.74 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 H5216-283 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-283 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $154.74 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-283 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-283 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $154.74 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-283 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-283 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $154.74 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-283 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-283 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $154.74 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 H5216-399 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-399 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.93 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Nursing Home Plan IL-F001 (PPO I-SNP)
![Email Prescription and/or Health Benefit details for UHC Nursing Home Plan IL-F001 (PPO I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.60 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $170.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Nursing Home Plan IL-F001 (PPO I-SNP)
![Email Prescription and/or Health Benefit details for UHC Nursing Home Plan IL-F001 (PPO I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.60 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $170.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Nursing Home Plan IL-F001 (PPO I-SNP)
![Email Prescription and/or Health Benefit details for UHC Nursing Home Plan IL-F001 (PPO I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.60 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $170.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Nursing Home Plan IL-F001 (PPO I-SNP)
![Email Prescription and/or Health Benefit details for UHC Nursing Home Plan IL-F001 (PPO I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.60 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $170.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Nursing Home Plan IL-F001 (PPO I-SNP)
![Email Prescription and/or Health Benefit details for UHC Nursing Home Plan IL-F001 (PPO I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.60 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $170.25 |
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 Nursing Home Plan IL-F001 (PPO I-SNP)
![Email Prescription and/or Health Benefit details for UHC Nursing Home Plan IL-F001 (PPO I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.60 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $170.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Nursing Home Plan IL-F001 (PPO I-SNP)
![Email Prescription and/or Health Benefit details for UHC Nursing Home Plan IL-F001 (PPO I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.60 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $170.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Nursing Home Plan IL-F001 (PPO I-SNP)
![Email Prescription and/or Health Benefit details for UHC Nursing Home Plan IL-F001 (PPO I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.60 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $170.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Nursing Home Plan IL-F001 (PPO I-SNP)
![Email Prescription and/or Health Benefit details for UHC Nursing Home Plan IL-F001 (PPO I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.60 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $170.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Nursing Home Plan IL-F001 (PPO I-SNP)
![Email Prescription and/or Health Benefit details for UHC Nursing Home Plan IL-F001 (PPO I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.60 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $170.25 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Nursing Home Plan IL-F001 (PPO I-SNP)
![Email Prescription and/or Health Benefit details for UHC Nursing Home Plan IL-F001 (PPO I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.60 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Tier 4 |
25% | 25% | None | $170.25 |
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 |
UW Health IL Quartz Med Advantage Value D(w/Rx) (HMO)
![Email Prescription and/or Health Benefit details for UW Health IL Quartz Med Advantage Value D(w/Rx) (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$250* |
Yes, but No Gap Coverage for this drug. |
2* |
Generic |
$20.00 | $50.00 | P | $739.17 |
Browse Plan Formulary all covered insulin pay $35 or less |
UW Health IL Quartz Med Advantage Value D(w/Rx) (HMO)
![Email Prescription and/or Health Benefit details for UW Health IL Quartz Med Advantage Value D(w/Rx) (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$250* |
Yes, but No Gap Coverage for this drug. |
2* |
Generic |
$20.00 | $50.00 | P | $739.17 |
Browse Plan Formulary all covered insulin pay $35 or less |
UW Health IL Quartz Med Advantage Value D(w/Rx) (HMO)
![Email Prescription and/or Health Benefit details for UW Health IL Quartz Med Advantage Value D(w/Rx) (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$250* |
Yes, but No Gap Coverage for this drug. |
2* |
Generic |
$20.00 | $50.00 | P | $739.17 |
Browse Plan Formulary all covered insulin pay $35 or less |
UW Health IL Quartz Med Advantage Value D(w/Rx) (HMO)
![Email Prescription and/or Health Benefit details for UW Health IL Quartz Med Advantage Value D(w/Rx) (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$250* |
Yes, but No Gap Coverage for this drug. |
2* |
Generic |
$20.00 | $50.00 | P | $739.17 |
Browse Plan Formulary all covered insulin pay $35 or less |
UW Health IL Quartz Med Advantage Value D(w/Rx) (HMO)
![Email Prescription and/or Health Benefit details for UW Health IL Quartz Med Advantage Value D(w/Rx) (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$250* |
Yes, but No Gap Coverage for this drug. |
2* |
Generic |
$20.00 | $50.00 | P | $739.17 |
Browse Plan Formulary all covered insulin pay $35 or less |
UW Health IL Quartz Med Advantage Value D(w/Rx) (HMO)
![Email Prescription and/or Health Benefit details for UW Health IL Quartz Med Advantage Value D(w/Rx) (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$250* |
Yes, but No Gap Coverage for this drug. |
2* |
Generic |
$20.00 | $50.00 | P | $739.17 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UW Health IL Quartz Med Advantage Value D(w/Rx) (HMO)
![Email Prescription and/or Health Benefit details for UW Health IL Quartz Med Advantage Value D(w/Rx) (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$250* |
Yes, but No Gap Coverage for this drug. |
2* |
Generic |
$20.00 | $50.00 | P | $739.17 |
Browse Plan Formulary all covered insulin pay $35 or less |
Longevity Health Plan (HMO I-SNP)
![Email Prescription and/or Health Benefit details for Longevity Health Plan (HMO I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.80 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
25% | n/a | Q:180 /30Days | $476.10 |
Browse Plan Formulary all covered insulin pay $35 or less |
Longevity Health Plan (HMO I-SNP)
![Email Prescription and/or Health Benefit details for Longevity Health Plan (HMO I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.80 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
25% | n/a | Q:180 /30Days | $476.10 |
Browse Plan Formulary all covered insulin pay $35 or less |
Longevity Health Plan (HMO I-SNP)
![Email Prescription and/or Health Benefit details for Longevity Health Plan (HMO I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.80 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
25% | n/a | Q:180 /30Days | $476.10 |
Browse Plan Formulary all covered insulin pay $35 or less |
Longevity Health Plan (HMO I-SNP)
![Email Prescription and/or Health Benefit details for Longevity Health Plan (HMO I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.80 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
25% | n/a | Q:180 /30Days | $476.10 |
Browse Plan Formulary all covered insulin pay $35 or less |
Longevity Health Plan (HMO I-SNP)
![Email Prescription and/or Health Benefit details for Longevity Health Plan (HMO I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.80 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
25% | n/a | Q:180 /30Days | $476.10 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Provider Partners Illinois Advantage Plan (HMO I-SNP)
![Email Prescription and/or Health Benefit details for Provider Partners Illinois Advantage Plan (HMO I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.80 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
25% | 25% | None | $815.63 |
Browse Plan Formulary all covered insulin pay $35 or less |
Provider Partners Illinois Advantage Plan (HMO I-SNP)
![Email Prescription and/or Health Benefit details for Provider Partners Illinois Advantage Plan (HMO I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.80 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
25% | 25% | None | $815.63 |
Browse Plan Formulary all covered insulin pay $35 or less |
Provider Partners Illinois Advantage Plan (HMO I-SNP)
![Email Prescription and/or Health Benefit details for Provider Partners Illinois Advantage Plan (HMO I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.80 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
25% | 25% | None | $815.63 |
Browse Plan Formulary all covered insulin pay $35 or less |
Provider Partners Illinois Advantage Plan (HMO I-SNP)
![Email Prescription and/or Health Benefit details for Provider Partners Illinois Advantage Plan (HMO I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.80 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
25% | 25% | None | $815.63 |
Browse Plan Formulary all covered insulin pay $35 or less |
Provider Partners Illinois Advantage Plan (HMO I-SNP)
![Email Prescription and/or Health Benefit details for Provider Partners Illinois Advantage Plan (HMO I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.80 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
25% | 25% | None | $815.63 |
Browse Plan Formulary all covered insulin pay $35 or less |
Provider Partners Illinois Advantage Plan (HMO I-SNP)
![Email Prescription and/or Health Benefit details for Provider Partners Illinois Advantage Plan (HMO I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.80 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
25% | 25% | None | $815.63 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Provider Partners Illinois Advantage Plan (HMO I-SNP)
![Email Prescription and/or Health Benefit details for Provider Partners Illinois Advantage Plan (HMO I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.80 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
1 |
Tier 1 |
25% | 25% | None | $815.63 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Care Advantage IL-E001 (PPO I-SNP)
![Email Prescription and/or Health Benefit details for UHC Care Advantage IL-E001 (PPO I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.80 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $170.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Care Advantage IL-E001 (PPO I-SNP)
![Email Prescription and/or Health Benefit details for UHC Care Advantage IL-E001 (PPO I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.80 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $170.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
UHC Care Advantage IL-E001 (PPO I-SNP)
![Email Prescription and/or Health Benefit details for UHC Care Advantage IL-E001 (PPO I-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.80 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $170.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Select Diabetes & Heart Complete IL (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Zing Select Diabetes & Heart Complete IL (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.80 |
$545 |
to be determined |
4 |
Tier 4 |
25% | 25% | Q:540 /30Days | tbd |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Select Diabetes & Heart Complete IL (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Zing Select Diabetes & Heart Complete IL (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.80 |
$545 |
to be determined |
4 |
Tier 4 |
25% | 25% | Q:540 /30Days | tbd |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Zing Select Diabetes & Heart Complete IL (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Zing Select Diabetes & Heart Complete IL (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.80 |
$545 |
to be determined |
4 |
Tier 4 |
25% | 25% | Q:540 /30Days | tbd |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Select Diabetes & Heart Complete IL (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Zing Select Diabetes & Heart Complete IL (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.80 |
$545 |
to be determined |
4 |
Tier 4 |
25% | 25% | Q:540 /30Days | tbd |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Select Diabetes & Heart Complete IL (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Zing Select Diabetes & Heart Complete IL (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.80 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
25% | 25% | Q:540 /30Days | $804.11 |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Select Diabetes & Heart Complete IL (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Zing Select Diabetes & Heart Complete IL (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.80 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
25% | 25% | Q:540 /30Days | $804.11 |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Select Diabetes & Heart Complete IL (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Zing Select Diabetes & Heart Complete IL (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.80 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
25% | 25% | Q:540 /30Days | $804.11 |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Select Diabetes & Heart Complete IL (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Zing Select Diabetes & Heart Complete IL (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.80 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
25% | 25% | Q:540 /30Days | $804.11 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Zing Select Diabetes & Heart Complete IL (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Zing Select Diabetes & Heart Complete IL (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.80 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
25% | 25% | Q:540 /30Days | $804.11 |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Select Diabetes & Heart Complete IL (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Zing Select Diabetes & Heart Complete IL (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.80 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
25% | 25% | Q:540 /30Days | $804.11 |
Browse Plan Formulary all covered insulin pay $35 or less |
Zing Select Diabetes & Heart Complete IL (HMO C-SNP)
![Email Prescription and/or Health Benefit details for Zing Select Diabetes & Heart Complete IL (HMO C-SNP)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.80 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
25% | 25% | Q:540 /30Days | $804.11 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0004 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0004 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None | $170.15 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0004 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0004 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None | $170.15 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0004 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0004 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None | $170.15 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IL-0004 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0004 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None | $170.15 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0004 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0004 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None | $170.15 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0004 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0004 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None | $170.15 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0004 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0004 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None | $170.15 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0004 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0004 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None | $170.15 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0004 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0004 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None | $170.15 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IL-0004 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0004 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None | $170.15 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0004 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0004 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None | $170.15 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0004 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0004 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None | $170.15 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0004 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0004 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None | $170.15 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0004 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0004 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None | $170.15 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ST-0001 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0001 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 ST-0001 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0001 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ST-0001 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0001 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ST-0001 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0001 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ST-0001 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0001 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ST-0001 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0001 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ST-0001 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0001 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 ST-0001 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0001 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ST-0001 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0001 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ST-0001 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0001 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ST-0001 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0001 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ST-0001 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0001 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ST-0001 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0001 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 ST-0001 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0001 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ST-0001 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0001 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ST-0001 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0001 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ST-0001 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0001 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ST-0001 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0001 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC ST-0001 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0001 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 ST-0001 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC ST-0001 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$95.00 | $275.00 | None | $164.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IA-0002 (HMO-POS)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IA-0002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $164.24 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Choice H8145-006 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-006 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Choice H8145-006 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-006 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.35 |
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 |
Humana Gold Choice H8145-006 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-006 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Choice H8145-006 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-006 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Choice H8145-006 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-006 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Choice H8145-006 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-006 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Choice H8145-006 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-006 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Choice H8145-006 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-006 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.35 |
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 |
Humana Gold Choice H8145-006 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-006 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Choice H8145-006 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-006 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Choice H8145-006 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-006 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Choice H8145-006 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-006 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Choice H8145-006 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-006 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Choice H8145-006 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-006 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.35 |
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 |
Humana Gold Choice H8145-006 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-006 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Choice H8145-006 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-006 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Choice H8145-006 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-006 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Choice H8145-006 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-006 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Choice H8145-006 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-006 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Choice H8145-006 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-006 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.35 |
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 |
Humana Gold Choice H8145-006 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-006 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Choice H8145-006 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-006 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Choice H8145-006 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-006 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Choice H8145-006 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-006 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Choice H8145-006 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-006 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Choice H8145-006 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-006 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.35 |
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 |
Humana Gold Choice H8145-006 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-006 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Choice H8145-006 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-006 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Choice H8145-006 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-006 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Choice H8145-006 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-006 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Choice H8145-006 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-006 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Choice H8145-006 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-006 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.35 |
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 |
Humana Gold Choice H8145-006 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-006 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Choice H8145-006 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-006 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Choice H8145-006 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-006 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Choice H8145-006 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-006 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Choice H8145-006 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-006 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Choice H8145-006 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-006 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.35 |
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 |
Humana Gold Choice H8145-006 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-006 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Choice H8145-006 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-006 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Choice H8145-006 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-006 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Choice H8145-006 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-006 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Choice H8145-006 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-006 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Choice H8145-006 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-006 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.35 |
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 |
Humana Gold Choice H8145-006 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-006 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Choice H8145-006 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-006 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Choice H8145-006 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-006 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Choice H8145-006 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-006 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.35 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
AARP Medicare Advantage from UHC IL-0003 (PPO)
![Email Prescription and/or Health Benefit details for AARP Medicare Advantage from UHC IL-0003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | None | $186.84 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H1468-014 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H1468-014 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.79 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 H1468-014 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H1468-014 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.79 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H1468-014 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H1468-014 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.79 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Plus H1468-014 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H1468-014 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $158.79 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Basic Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Basic Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Essence Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Essence Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.80 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$0.00 | $0.00 | None | $436.18 |
Browse Plan Formulary all covered insulin pay $35 or less |
Essence Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Essence Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.80 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$0.00 | $0.00 | None | $436.18 |
Browse Plan Formulary all covered insulin pay $35 or less |
Essence Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Essence Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.80 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$0.00 | $0.00 | None | $436.18 |
Browse Plan Formulary all covered insulin pay $35 or less |
Essence Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Essence Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.80 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$0.00 | $0.00 | None | $436.18 |
Browse Plan Formulary all covered insulin pay $35 or less |
Essence Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Essence Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.80 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$0.00 | $0.00 | None | $436.18 |
Browse Plan Formulary all covered insulin pay $35 or less |
Essence Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Essence Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.80 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$0.00 | $0.00 | None | $436.18 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Essence Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Essence Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.80 |
$0 |
Yes, this drug has Gap Coverage. |
2 |
Generic |
$0.00 | $0.00 | None | $436.18 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-032 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-032 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$61.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$99.00 | $287.00 | Q:540 /30Days | $153.92 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-032 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-032 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$61.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$99.00 | $287.00 | Q:540 /30Days | $153.92 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-032 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-032 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$61.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$99.00 | $287.00 | Q:540 /30Days | $153.92 |
Browse Plan Formulary all covered insulin pay $35 or less |
UW Health IL Quartz Med Advantage Elite D(w/Rx) (HMO)
![Email Prescription and/or Health Benefit details for UW Health IL Quartz Med Advantage Elite D(w/Rx) (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$68.00 |
$200* |
Yes, but No Gap Coverage for this drug. |
2* |
Generic |
$20.00 | $50.00 | P | $739.17 |
Browse Plan Formulary all covered insulin pay $35 or less |
UW Health IL Quartz Med Advantage Elite D(w/Rx) (HMO)
![Email Prescription and/or Health Benefit details for UW Health IL Quartz Med Advantage Elite D(w/Rx) (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$68.00 |
$200* |
Yes, but No Gap Coverage for this drug. |
2* |
Generic |
$20.00 | $50.00 | P | $739.17 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UW Health IL Quartz Med Advantage Elite D(w/Rx) (HMO)
![Email Prescription and/or Health Benefit details for UW Health IL Quartz Med Advantage Elite D(w/Rx) (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$68.00 |
$200* |
Yes, but No Gap Coverage for this drug. |
2* |
Generic |
$20.00 | $50.00 | P | $739.17 |
Browse Plan Formulary all covered insulin pay $35 or less |
UW Health IL Quartz Med Advantage Elite D(w/Rx) (HMO)
![Email Prescription and/or Health Benefit details for UW Health IL Quartz Med Advantage Elite D(w/Rx) (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$68.00 |
$200* |
Yes, but No Gap Coverage for this drug. |
2* |
Generic |
$20.00 | $50.00 | P | $739.17 |
Browse Plan Formulary all covered insulin pay $35 or less |
UW Health IL Quartz Med Advantage Elite D(w/Rx) (HMO)
![Email Prescription and/or Health Benefit details for UW Health IL Quartz Med Advantage Elite D(w/Rx) (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$68.00 |
$200* |
Yes, but No Gap Coverage for this drug. |
2* |
Generic |
$20.00 | $50.00 | P | $739.17 |
Browse Plan Formulary all covered insulin pay $35 or less |
UW Health IL Quartz Med Advantage Elite D(w/Rx) (HMO)
![Email Prescription and/or Health Benefit details for UW Health IL Quartz Med Advantage Elite D(w/Rx) (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$68.00 |
$200* |
Yes, but No Gap Coverage for this drug. |
2* |
Generic |
$20.00 | $50.00 | P | $739.17 |
Browse Plan Formulary all covered insulin pay $35 or less |
UW Health IL Quartz Med Advantage Elite D(w/Rx) (HMO)
![Email Prescription and/or Health Benefit details for UW Health IL Quartz Med Advantage Elite D(w/Rx) (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$68.00 |
$200* |
Yes, but No Gap Coverage for this drug. |
2* |
Generic |
$20.00 | $50.00 | P | $739.17 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Premier Plus (HMO-POS)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Premier Plus (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$76.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $397.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Premier Plus (HMO-POS)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Premier Plus (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$76.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $397.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Premier Plus (HMO-POS)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Premier Plus (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$76.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $397.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Premier Plus (HMO-POS)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Premier Plus (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$76.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $397.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Premier Plus (HMO-POS)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Premier Plus (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$76.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $397.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Premier Plus (HMO-POS)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Premier Plus (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$76.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $397.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Premier Plus (HMO-POS)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Premier Plus (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$76.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $397.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Premier Plus (HMO-POS)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Premier Plus (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$76.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $397.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Premier Plus (HMO-POS)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Premier Plus (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$76.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $397.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Choice Plus (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Choice Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$77.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $397.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Choice Plus (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Choice Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$77.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $397.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Choice Plus (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Choice Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$77.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $397.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Choice Plus (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Choice Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$77.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $397.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Choice Plus (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Choice Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$77.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $397.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Choice Plus (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Choice Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$77.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $397.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Choice Plus (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Choice Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$77.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $397.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Choice Plus (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Choice Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$77.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $397.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Choice Plus (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Choice Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$77.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $397.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice R5361-002 (Regional PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice R5361-002 (Regional PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$97.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
25% | 25% | Q:540 /30Days | $155.59 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 H5216-013 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-013 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$100.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-013 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-013 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$100.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-013 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-013 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$100.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-013 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-013 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$100.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-013 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-013 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$100.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-013 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-013 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$100.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 H5216-013 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-013 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$100.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-013 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-013 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$100.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-013 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-013 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$100.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-013 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-013 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$100.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-013 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-013 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$100.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-013 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-013 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$100.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 H5216-013 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-013 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$100.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-013 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-013 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$100.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-013 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-013 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$100.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-013 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-013 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$100.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-013 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-013 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$100.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-013 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-013 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$100.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 H5216-013 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-013 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$100.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-013 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-013 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$100.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-013 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-013 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$100.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-013 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-013 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$100.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-013 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-013 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$100.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-013 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-013 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$100.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 H5216-013 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-013 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$100.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-013 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-013 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$100.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-013 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-013 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$100.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $155.37 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-004 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-004 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$100.00 |
$300 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $156.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-004 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-004 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$100.00 |
$300 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $156.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-004 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-004 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$100.00 |
$300 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $156.40 |
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 |
HumanaChoice H5525-004 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-004 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$100.00 |
$300 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $156.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-004 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-004 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$100.00 |
$300 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $156.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-004 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-004 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$100.00 |
$300 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $156.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-004 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-004 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$100.00 |
$300 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $156.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-004 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-004 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$100.00 |
$300 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $156.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-004 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-004 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$100.00 |
$300 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $156.40 |
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 |
HumanaChoice H5525-004 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-004 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$100.00 |
$300 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $156.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-004 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-004 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$100.00 |
$300 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $156.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-004 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-004 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$100.00 |
$300 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $156.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-004 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-004 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$100.00 |
$300 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $156.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-004 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-004 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$100.00 |
$300 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $156.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-004 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-004 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$100.00 |
$300 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $156.40 |
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 |
HumanaChoice H5525-004 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-004 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$100.00 |
$300 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $156.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-004 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-004 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$100.00 |
$300 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $156.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-004 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-004 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$100.00 |
$300 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $156.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-004 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-004 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$100.00 |
$300 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $156.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-004 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-004 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$100.00 |
$300 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $156.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-004 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-004 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$100.00 |
$300 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $156.40 |
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 |
HumanaChoice H5525-004 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-004 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$100.00 |
$300 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $156.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-004 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-004 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$100.00 |
$300 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $156.40 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare HMO 20 Rx (HMO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare HMO 20 Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$125.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Humana Gold Choice H8145-122 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-122 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$132.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$99.00 | $287.00 | Q:540 /30Days | $156.10 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 Choice H8145-122 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H8145-122 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$132.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$99.00 | $287.00 | Q:540 /30Days | $156.10 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Choice Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Choice Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$135.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $397.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Choice Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Choice Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$135.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $397.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Choice Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Choice Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$135.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $397.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Choice Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Choice Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$135.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $397.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Choice Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Choice Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$135.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $397.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Choice Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Choice Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$135.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $397.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Choice Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Choice Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$135.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $397.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Choice Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Choice Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$135.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $397.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Choice Premier (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Choice Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$135.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $397.44 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-357 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-357 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$138.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $154.74 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-357 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-357 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$138.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $154.74 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 H5216-357 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-357 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$138.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $154.74 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-357 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-357 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$138.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $154.74 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-357 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-357 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$138.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $154.74 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-357 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-357 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$138.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $154.74 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-357 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-357 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$138.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $154.74 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-357 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-357 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$138.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $154.74 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 H5216-357 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-357 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$138.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $154.74 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-357 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-357 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$138.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $154.74 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-357 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-357 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$138.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $154.74 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-357 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-357 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$138.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $154.74 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-357 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-357 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$138.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $154.74 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5216-357 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-357 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$138.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $154.74 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
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 H5525-069 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-069 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$138.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $153.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-069 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-069 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$138.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $153.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-069 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-069 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$138.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $153.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-069 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-069 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$138.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $153.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-069 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-069 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$138.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $153.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-069 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-069 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$138.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $153.00 |
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 |
HumanaChoice H5525-069 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-069 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$138.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $153.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-069 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-069 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$138.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $153.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-069 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-069 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$138.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $153.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-069 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-069 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$138.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $153.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-069 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-069 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$138.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $153.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-069 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-069 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$138.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $153.00 |
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 |
HumanaChoice H5525-069 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-069 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$138.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $153.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-069 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-069 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$138.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $153.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-069 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-069 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$138.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $153.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-069 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-069 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$138.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $153.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-069 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-069 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$138.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $153.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
HumanaChoice H5525-069 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-069 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$138.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $153.00 |
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 |
HumanaChoice H5525-069 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-069 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$138.00 |
$545 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
$100.00 | $290.00 | Q:540 /30Days | $153.00 |
Browse Plan Formulary all covered insulin pay $35 or less |
OSF with Medica Advantage Preferred (HMO-POS)
![Email Prescription and/or Health Benefit details for OSF with Medica Advantage Preferred (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$160.00 |
$200* |
Yes, but No Gap Coverage for this drug. |
2* |
Generic |
$8.00 | $0.00 | None | $641.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
OSF with Medica Advantage Preferred (HMO-POS)
![Email Prescription and/or Health Benefit details for OSF with Medica Advantage Preferred (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$160.00 |
$200* |
Yes, but No Gap Coverage for this drug. |
2* |
Generic |
$8.00 | $0.00 | None | $641.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
OSF with Medica Advantage Preferred (HMO-POS)
![Email Prescription and/or Health Benefit details for OSF with Medica Advantage Preferred (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$160.00 |
$200* |
Yes, but No Gap Coverage for this drug. |
2* |
Generic |
$8.00 | $0.00 | None | $641.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
OSF with Medica Advantage Preferred (HMO-POS)
![Email Prescription and/or Health Benefit details for OSF with Medica Advantage Preferred (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$160.00 |
$200* |
Yes, but No Gap Coverage for this drug. |
2* |
Generic |
$8.00 | $0.00 | None | $641.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
OSF with Medica Advantage Preferred (HMO-POS)
![Email Prescription and/or Health Benefit details for OSF with Medica Advantage Preferred (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$160.00 |
$200* |
Yes, but No Gap Coverage for this drug. |
2* |
Generic |
$8.00 | $0.00 | None | $641.70 |
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 |
OSF with Medica Advantage Preferred (HMO-POS)
![Email Prescription and/or Health Benefit details for OSF with Medica Advantage Preferred (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$160.00 |
$200* |
Yes, but No Gap Coverage for this drug. |
2* |
Generic |
$8.00 | $0.00 | None | $641.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
OSF with Medica Advantage Preferred (HMO-POS)
![Email Prescription and/or Health Benefit details for OSF with Medica Advantage Preferred (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$160.00 |
$200* |
Yes, but No Gap Coverage for this drug. |
2* |
Generic |
$8.00 | $0.00 | None | $641.70 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS 10 Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS 10 Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$0 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Enrich Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Enrich Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare POS Enrich Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Enrich Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Enrich Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Enrich Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Enrich Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Enrich Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Enrich Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Enrich Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Enrich Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Enrich Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Enrich Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Enrich Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare POS Enrich Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Enrich Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Enrich Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Enrich Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Enrich Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Enrich Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Enrich Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Enrich Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Enrich Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Enrich Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Enrich Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Enrich Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare POS Enrich Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Enrich Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Enrich Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Enrich Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Enrich Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Enrich Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Health Alliance Medicare POS Enrich Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare POS Enrich Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$165.00 |
$250 |
Yes, but No Gap Coverage for this drug. |
4 |
Non-Preferred Drug |
50% | 50% | None | $715.83 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Plan Name |
Monthly Prem. |
De- duct- ible |
Additional Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |
Blue Cross Medicare Advantage Flex (PPO)
![Email Prescription and/or Health Benefit details for Blue Cross Medicare Advantage Flex (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$202.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount |
4 |
Non-Preferred Drug |
$100.00 | $300.00 | Q:270 /30Days | $431.27 |
Browse Plan Formulary all covered insulin pay $35 or less |