Seniors Insurance Online!
Plan Summary
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Review the plans available in your region (KENTUCKY). |
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Bronze |
Gold |
Platinum |
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Monthly Premium |
$28.40 |
$31.40 |
$64.80 |
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Deductible |
$275 |
$0 |
$0 |
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Generic Drug Co-pays (30-day supply) |
25% |
$6 |
$6 |
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Brand Drug Co-pays (30-day supply) |
25% |
$44 |
$44 |
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Generic Drug Co-pays (90-day supply*) |
25% |
$12 |
$12 |
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Brand Drug Co-pays (90-day supply*) |
25% |
$88 |
$88 |
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Specialty Drug Co-insurance |
25% |
33% |
33% |
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Initial Coverage Limit |
$2,510 |
$2,510 |
$2,510 |
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Coverage Gap Benefits |
No |
No |
$6 for 30-day supply of
generic drugs
$12 for 90-day supply of generic drugs* |
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* Available at select network pharmacies or
through mail order. |
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 |
Check the formulary to make sure your prescriptions (or acceptable
alternatives) are covered. |
Formulary/Drug Search |
| Review the plans available in your region (TENNESSEE) |
| |
|
Bronze |
Gold |
Platinum |
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Monthly Premium |
$24.20 |
$30.70 |
$62.20 |
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Deductible |
$275 |
$0 |
$0 |
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Generic Drug Co-pays (30-day supply) |
25% |
$6 |
$6 |
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Brand Drug Co-pays (30-day supply) |
25% |
$44 |
$44 |
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Generic Drug Co-pays (90-day supply*) |
25% |
$12 |
$12 |
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Brand Drug Co-pays (90-day supply*) |
25% |
$88 |
$88 |
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Specialty Drug Co-insurance |
25% |
33% |
33% |
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Initial Coverage Limit |
$2,510 |
$2,510 |
$2,510 |
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| |
Coverage Gap Benefits |
No |
No |
$6 for 30-day supply of
generic drugs
$12 for 90-day supply of generic drugs* |
| |
* Available at select network pharmacies or
through mail order. |
|
|
Check the formulary to make sure your prescriptions (or acceptable
alternatives) are covered. |
Formulary/Drug Search
|
|
Review the plans available in your region (VIRGINIA). |
| |
|
Bronze |
Gold |
Platinum |
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|
|
|
|
| |
Monthly Premium |
$25.80 |
$29.90 |
$61.20 |
|
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|
|
|
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Deductible |
$275 |
$0 |
$0 |
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|
|
|
| |
Generic Drug Co-pays (30-day supply) |
25% |
$6 |
$6 |
|
|
|
|
|
| |
Brand Drug Co-pays (30-day supply) |
25% |
$44 |
$44 |
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Generic Drug Co-pays (90-day supply*) |
25% |
$12 |
$12 |
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|
|
| |
Brand Drug Co-pays (90-day supply*) |
25% |
$88 |
$88 |
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|
|
|
| |
Specialty Drug Co-insurance |
25% |
33% |
33% |
|
|
|
|
|
| |
Initial Coverage Limit |
$2,510 |
$2,510 |
$2,510 |
|
|
|
|
|
| |
Coverage Gap Benefits |
No |
No |
$6 for 30-day supply of
generic drugs
$12 for 90-day supply of generic drugs* |
| |
* Available at select network pharmacies or
through mail order. |
|
|
Check the formulary to make sure your prescriptions (or acceptable
alternatives) are covered. |
Formulary/Drug Search
|
Call 1-800-766-1725 to enroll
|
Oct, 2007
