*You must continue to pay your Medicare Part B premium.
**The plan’s monthly premium is paid by Medicare’s Extra Help program. The Medicare Part B premium is paid by the state of Louisiana. You must continue to pay your Medicare Part B premium if not paid by the state or another third party.
†One Pass is a trademark of Optum, Inc. and/or its affiliates. © 2022 Optum, Inc.
††You will pay a maximum of $35 for each 1-month supply of Part D select insulin drugs through all coverage stages
†††You won’t pay more than $0 for a one-month supply of each insulin product covered by your plan through all coverage stages