Standard Bronze On Exchange Plan
Bronze Standard
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC13601*XNVAHZO
1
Standard Silver On Exchange Plan
Silver Standard
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC13901*XNVAHZO
1
Standard Silver On Exchange Plan
Silver Complete
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC11701*XNVAHZO
1
Standard Bronze On Exchange Plan
Bronze Complete+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC11401*XNVAHZO
1
Standard Gold On Exchange Plan
Gold Standard
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC14501*XNVAHZO
1
Standard Catastrophic On Exchange Plan
Catastrophic Standard
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC13501*XNVAHZO
1
Standard Silver On Exchange Plan
Silver Complete+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC12301*XNVAHZO
1
Standard Gold On Exchange Plan
Gold Complete+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC13201*XNVAHZO
1
Standard Bronze On Exchange Plan
Bronze Elite
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC14801*XNVAHZO
1
Standard Bronze On Exchange Plan
Bronze Elite+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC15101*XNVAHZO
1
Standard Silver On Exchange Plan
Silver Elite
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC15401*XNVAHZO
1
Standard Silver On Exchange Plan
Silver Elite+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC16001*XNVAHZO
1
Standard Gold On Exchange Plan
Gold Elite+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC16901*XNVAHZO
1
Standard Gold On Exchange Plan
Gold Elite
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC16601*XNVAHZO
1
Zero Cost Sharing Plan Variation
Bronze Standard
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC13701*XNVAHZO
2
73% AV Level Silver Plan
Silver Standard
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC14201*XNVAHZO
2
Standard Catastrophic Off Exchange Plan
Catastrophic Standard
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC17801*NVAHZX
2
Zero Cost Sharing Plan Variation
Bronze Complete+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC11501*XNVAHZO
2
Zero Cost Sharing Plan Variation
Gold Standard
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC14601*XNVAHZO
2
73% AV Level Silver Plan
Silver Complete
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC12001*XNVAHZO
2
73% AV Level Silver Plan
Silver Complete+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC12601*XNVAHZO
2
Zero Cost Sharing Plan Variation
Gold Complete+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC13301*XNVAHZO
2
Zero Cost Sharing Plan Variation
Bronze Elite+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC15201*XNVAHZO
2
Zero Cost Sharing Plan Variation
Bronze Elite
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC14901*XNVAHZO
2
73% AV Level Silver Plan
Silver Elite
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC15701*XNVAHZO
2
73% AV Level Silver Plan
Silver Elite+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC16301*XNVAHZO
2
Zero Cost Sharing Plan Variation
Gold Elite
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC16701*XNVAHZO
2
Zero Cost Sharing Plan Variation
Gold Elite+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC17001*XNVAHZO
2
87% AV Level Silver Plan
Silver Standard
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC14301*XNVAHZO
3
Limited Cost Sharing Plan Variation
Bronze Standard
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC13801*XNVAHZO
3
Limited Cost Sharing Plan Variation
Gold Standard
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC14701*XNVAHZO
3
87% AV Level Silver Plan
Silver Complete
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC12101*XNVAHZO
3
Limited Cost Sharing Plan Variation
Bronze Complete+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC11601*XNVAHZO
3
87% AV Level Silver Plan
Silver Complete+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC12701*XNVAHZO
3
Limited Cost Sharing Plan Variation
Gold Complete+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC13401*XNVAHZO
3
Limited Cost Sharing Plan Variation
Bronze Elite
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC15001*XNVAHZO
3
87% AV Level Silver Plan
Silver Elite
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC15801*XNVAHZO
3
87% AV Level Silver Plan
Silver Elite+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC16401*XNVAHZO
3
Limited Cost Sharing Plan Variation
Gold Elite+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC17101*XNVAHZO
3
Limited Cost Sharing Plan Variation
Gold Elite
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC16801*XNVAHZO
3
Standard Gold Off Exchange Plan
Gold Standard
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC18101*NVAHZX
4
Standard Bronze Off Exchange Plan
Bronze Standard
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC17901*NVAHZX
4
94% AV Level Silver Plan
Silver Standard
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC14401*XNVAHZO
4
Standard Bronze Off Exchange Plan
Bronze Complete+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC17301*NVAHZX
4
94% AV Level Silver Plan
Silver Complete
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC12201*XNVAHZO
4
94% AV Level Silver Plan
Silver Complete+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC12801*XNVAHZO
4
Standard Gold Off Exchange Plan
Gold Complete+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC17701*NVAHZX
4
Standard Bronze Off Exchange Plan
Bronze Elite
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC18201*NVAHZX
4
94% AV Level Silver Plan
Silver Elite
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC15901*XNVAHZO
4
94% AV Level Silver Plan
Silver Elite+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC16501*XNVAHZO
4
Standard Gold Off Exchange Plan
Gold Elite+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC18701*NVAHZX
4
Standard Gold Off Exchange Plan
Gold Elite
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC18601*NVAHZX
4
Limited Cost Sharing Plan Variation
Silver Standard
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC14101*XNVAHZO
5
Standard Bronze On Exchange Plan
Bronze Complete
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC11101*XNVAHZO
5
Limited Cost Sharing Plan Variation
Silver Complete
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC11901*XNVAHZO
5
Limited Cost Sharing Plan Variation
Silver Complete+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC12501*XNVAHZO
5
Standard Gold On Exchange Plan
Gold Complete
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC12901*XNVAHZO
5
Limited Cost Sharing Plan Variation
Silver Elite
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC15601*XNVAHZO
5
Limited Cost Sharing Plan Variation
Silver Elite+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC16201*XNVAHZO
5
Zero Cost Sharing Plan Variation
Silver Standard
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC14001*XNVAHZO
6
Zero Cost Sharing Plan Variation
Bronze Complete
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC11201*XNVAHZO
6
Zero Cost Sharing Plan Variation
Silver Complete+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC12401*XNVAHZO
6
Zero Cost Sharing Plan Variation
Silver Complete
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC11801*XNVAHZO
6
Zero Cost Sharing Plan Variation
Gold Complete
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC13001*XNVAHZO
6
Zero Cost Sharing Plan Variation
Silver Elite
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC15501*XNVAHZO
6
Zero Cost Sharing Plan Variation
Silver Elite+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC16101*XNVAHZO
6
Standard Silver Off Exchange Plan
Silver Standard
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC18001*NVAHZX
7
Standard Silver Off Exchange Plan
Silver Standard
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC18801*NVAHZX
7
Limited Cost Sharing Plan Variation
Bronze Complete
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC11301*XNVAHZO
7
Standard Silver Off Exchange Plan
Silver Complete
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC17401*NVAHZX
7
Standard Silver Off Exchange Plan
Silver Complete+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC17501*NVAHZX
7
Standard Silver Off Exchange Plan
Silver Complete
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC18901*NVAHZX
7
Limited Cost Sharing Plan Variation
Gold Complete
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC13101*XNVAHZO
7
Standard Silver Off Exchange Plan
Silver Complete+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC19001*NVAHZX
7
Standard Silver Off Exchange Plan
Silver Elite
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC18401*NVAHZX
7
Standard Silver Off Exchange Plan
Silver Elite+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC18501*NVAHZX
7
Standard Silver Off Exchange Plan
Silver Elite
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC19101*NVAHZX
7
Standard Silver Off Exchange Plan
Silver Elite+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC19201*NVAHZX
7
Standard Bronze Off Exchange Plan
Bronze Complete
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC17201*NVAHZX
8
Standard Gold Off Exchange Plan
Gold Complete
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC17601*NVAHZX
8
Limited Cost Sharing Plan Variation
Bronze Elite+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC15301*XNVAHZO
11
Standard Bronze Off Exchange Plan
Bronze Elite+Dental
https://memberportal.navitus.com/micro-sites/pharmacy-pricing?entrypoint=drug&type=standard&header=false&footer=false&id=PUBLIC18301*NVAHZX
13