PEG-INTRON REDIPEN PAK 4 (120 MCG/0.5ML 4PAK CTR) (NDC: 00085129702)
2010 Medicare Prescription Drug Plan (MAPD) Information
Click here for the Chart Legend |
Plan Name |
Monthly Prem. |
De- duct- ible |
Does Plan Offer 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 |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $2,342.82 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $2,342.82 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $2,342.82 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $2,342.82 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $2,342.82 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $2,342.82 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $2,342.82 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $2,342.82 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $2,342.82 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $2,342.82 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $2,342.82 |
Browse Plan Formulary |
|
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $2,342.82 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $2,342.82 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $2,342.82 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $2,342.82 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $2,342.82 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $2,342.82 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $2,342.82 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $2,342.82 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $2,342.82 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $2,342.82 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $2,342.82 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $2,342.82 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $2,342.82 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $2,342.82 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $2,342.82 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $2,342.82 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $2,342.82 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $2,342.82 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $2,342.82 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $2,342.82 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $2,342.82 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $2,342.82 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $2,342.82 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $2,342.82 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $2,342.82 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $2,342.82 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $2,342.82 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $2,342.82 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $2,342.82 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $2,342.82 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $2,342.82 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $2,342.82 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $2,342.82 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $2,342.82 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $2,342.82 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $2,342.82 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$6.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,273.29 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$6.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,267.48 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$6.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,266.07 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$6.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,266.07 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$6.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,266.07 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$6.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,266.07 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$6.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,266.07 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.30 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,270.42 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.30 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,270.42 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.30 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,270.42 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.30 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,270.42 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.30 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,270.42 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.30 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,270.42 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.30 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,270.42 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.30 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,270.42 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.30 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,270.42 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.30 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,270.42 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.30 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,270.42 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.30 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,270.42 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.30 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,270.42 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.30 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,270.42 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.30 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,270.42 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.30 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,270.42 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.30 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,270.42 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.30 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,270.42 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.30 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,270.42 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.30 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,270.42 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,254.35 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.60 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,267.28 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.60 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,267.28 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.60 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,267.28 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.60 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,267.28 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.60 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,267.28 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.60 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,267.28 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.60 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,267.28 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.60 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,267.28 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.60 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,267.28 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.60 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,267.28 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.60 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,267.28 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.60 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,267.28 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.60 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,267.28 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.60 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,267.28 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.70 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,268.83 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.70 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,268.83 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.70 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,268.83 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.70 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,268.83 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.70 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,268.83 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.70 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,268.83 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.70 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,268.83 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.70 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,268.83 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.70 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,268.83 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.70 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,268.83 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.70 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,268.83 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,273.29 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-044 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-044 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,185.89 |
Browse Plan Formulary |
Humana Gold Choice H2944-044 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-044 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,185.89 |
Browse Plan Formulary |
Humana Gold Choice H2944-044 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-044 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,185.89 |
Browse Plan Formulary |
Humana Gold Choice H2944-044 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-044 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,185.89 |
Browse Plan Formulary |
Humana Gold Choice H2944-044 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-044 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,185.89 |
Browse Plan Formulary |
Fidelis Secure at Home (HMO)
![Email Prescription and/or Health Benefit details for Fidelis Secure at Home (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,225.52 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Fidelis Secure at Home (HMO)
![Email Prescription and/or Health Benefit details for Fidelis Secure at Home (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,225.52 |
Browse Plan Formulary |
Fidelis Secure at Home (HMO)
![Email Prescription and/or Health Benefit details for Fidelis Secure at Home (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,225.52 |
Browse Plan Formulary |
Fidelis Secure at Home (HMO)
![Email Prescription and/or Health Benefit details for Fidelis Secure at Home (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,225.52 |
Browse Plan Formulary |
Fidelis Secure at Home (HMO)
![Email Prescription and/or Health Benefit details for Fidelis Secure at Home (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,225.52 |
Browse Plan Formulary |
Fidelis Secure at Home (HMO)
![Email Prescription and/or Health Benefit details for Fidelis Secure at Home (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,225.52 |
Browse Plan Formulary |
Fidelis Secure at Home (HMO)
![Email Prescription and/or Health Benefit details for Fidelis Secure at Home (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,225.52 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Fidelis Secure at Home (HMO)
![Email Prescription and/or Health Benefit details for Fidelis Secure at Home (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,225.52 |
Browse Plan Formulary |
Fidelis Secure at Home (HMO)
![Email Prescription and/or Health Benefit details for Fidelis Secure at Home (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,225.52 |
Browse Plan Formulary |
Fidelis Secure at Home (HMO)
![Email Prescription and/or Health Benefit details for Fidelis Secure at Home (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,225.52 |
Browse Plan Formulary |
Fidelis Secure at Home (HMO)
![Email Prescription and/or Health Benefit details for Fidelis Secure at Home (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,225.52 |
Browse Plan Formulary |
Fidelis Secure at Home (HMO)
![Email Prescription and/or Health Benefit details for Fidelis Secure at Home (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,225.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-047 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-047 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,227.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-047 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-047 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,227.53 |
Browse Plan Formulary |
Humana Gold Choice H2944-047 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-047 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,227.53 |
Browse Plan Formulary |
Humana Gold Choice H2944-047 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-047 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,227.53 |
Browse Plan Formulary |
Humana Gold Choice H2944-047 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-047 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,227.53 |
Browse Plan Formulary |
Humana Gold Choice H2944-047 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-047 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,227.53 |
Browse Plan Formulary |
Humana Gold Choice H2944-047 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-047 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,227.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-047 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-047 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,227.53 |
Browse Plan Formulary |
Humana Gold Choice H2944-047 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-047 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,227.53 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,266.07 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,266.07 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,266.07 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,266.07 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,266.07 |
Browse Plan Formulary |
Humana Gold Choice H2944-051 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-051 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,214.11 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,215.49 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option A (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,254.35 |
Browse Plan Formulary |
HumanaChoice H5470-004 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5470-004 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,214.11 |
Browse Plan Formulary |
Molina Medicare Options (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare Options (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.70 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,240.98 |
Browse Plan Formulary |
Molina Medicare Options (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare Options (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.70 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,240.98 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-049 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,195.06 |
Browse Plan Formulary |
HumanaChoice R5826-006 (Regional PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice R5826-006 (Regional PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,211.68 |
Browse Plan Formulary |
HumanaChoice R5826-072 (Regional PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice R5826-072 (Regional PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.60 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P Q:4 /28Days | $2,211.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-046 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-046 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,219.63 |
Browse Plan Formulary |
Humana Gold Choice H2944-046 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-046 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,219.63 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-046 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-046 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,219.63 |
Browse Plan Formulary |
Humana Gold Choice H2944-046 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-046 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,219.63 |
Browse Plan Formulary |
Humana Gold Choice H2944-046 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-046 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,219.63 |
Browse Plan Formulary |
Humana Gold Choice H2944-046 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-046 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,219.63 |
Browse Plan Formulary |
Humana Gold Choice H2944-046 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-046 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,219.63 |
Browse Plan Formulary |
Healthy Advantage (HMO)
![Email Prescription and/or Health Benefit details for Healthy Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,240.98 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Healthy Advantage (HMO)
![Email Prescription and/or Health Benefit details for Healthy Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,240.98 |
Browse Plan Formulary |
Healthy Advantage (HMO)
![Email Prescription and/or Health Benefit details for Healthy Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,240.98 |
Browse Plan Formulary |
Healthy Advantage (HMO)
![Email Prescription and/or Health Benefit details for Healthy Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,240.98 |
Browse Plan Formulary |
Healthy Advantage (HMO)
![Email Prescription and/or Health Benefit details for Healthy Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,240.98 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,267.48 |
Browse Plan Formulary |
Medicare Plus Blue PPO (PPO)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue PPO (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.50 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue PPO (PPO)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue PPO (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.50 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue PPO (PPO)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue PPO (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.50 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue PPO (PPO)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue PPO (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.50 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue PPO (PPO)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue PPO (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.50 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue PPO (PPO)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue PPO (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.50 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,214.32 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,187.53 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
![Email Prescription and/or Health Benefit details for Medicare Plus Blue Option B (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.40 |
$0 |
to be determined |
4 |
Tier 4 |
25% | n/a | Q:4 /28Days | $2,274.72 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,270.42 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,270.42 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,270.42 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,270.42 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,270.42 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,270.42 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,270.42 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,270.42 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,270.42 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,270.42 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,270.42 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,270.42 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,270.42 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,270.42 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,270.42 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,270.42 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,270.42 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,270.42 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,270.42 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,270.42 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,266.54 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,266.54 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,266.54 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,266.54 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,266.54 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,266.54 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,266.54 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,266.54 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,266.54 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$50.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,267.28 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$50.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,267.28 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$50.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,267.28 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$50.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,267.28 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$50.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,267.28 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$50.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,267.28 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$50.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,267.28 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$50.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,267.28 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$50.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,267.28 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$50.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,267.28 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$50.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,267.28 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$50.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,267.28 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$50.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,267.28 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$50.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,267.28 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,268.83 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,268.83 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,268.83 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,268.83 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,268.83 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,268.83 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,268.83 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,268.83 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,268.83 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,268.83 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,268.83 |
Browse Plan Formulary |