Plan Details
Plan Year: | 2018 |
---|---|
Prescription Drugs Covered? | Yes |
Health Plan Deductible | $0 |
Monthly Drug Plan Premium | $0 |
Monthly Health Plan Premium | $0 |
Coverage Area for Neighborhood INTEGRITY (Medicare-Medicaid )
State | Rhode Island |
---|---|
County | Providence |
Cost Sharing Information
All cost-sharing assumes in-network healthcare providers.
Prescription Drug Copay/Coninsurance Details - Initial Coverage Limit
30 Day Supply | Preferred Retail Pharmacies | Non-Preferred Retail Pharmacies | Mail-Order Pharmacies |
---|---|---|---|
Tier 1: Preferred Generic | Not offereds | 0% coinsurance | Not offered |
Tier 2: Non-Preferred Generic | Not offered | 0% coinsurance | Not offered |
Tier 3: Preferred Brand Name | Not offered | 0% coinsurance | Not offered |
Tier 4: Non-Preferred Brand Name | |||
Tier 5: Specialty Tier |
90 Day Supply | Preferred Retail Pharmacies | Non-Preferred Retail Pharmacies | Mail-Order Pharmacies |
---|---|---|---|
Tier 1: Preferred Generic | Not offered | 0% coinsurance | Not offered |
Tier 2: Non-Preferred Generic | Not offered | 0% coinsurance | Not offered |
Tier 3: Preferred Brand Name | Not offered | 0% coinsurance | Not offered |
Tier 4: Non-Preferred Brand Name | |||
Tier 5: Specialty Tier |
Physician Finder
Physicians that accept Neighborhood INTEGRITY (Medicare-Medicaid ) for Rhode Island