CVS Caremark Value, FL 2013 PDP

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Summary Rating:This Medicare drug plan has an average rating of 3.0
Initial Coverage Limit:$2,970.00
Mail Order:Yes
Gap Coverage:No Gap Coverage
$0 Premium LIS Benefit:No
Drugs in Formulary:2837
Drug Plan ID:S5601-022
Plan Year:2013
CMS Approved for:FL Residents
Plan Type:National
Members in Region:169781

PDP Plan Highlights

Active Florida Senior, Medicare Part D Plan: CVS Caremark Value (PDP) S5601-022FL CVS Caremark Value (PDP) is a Medicare prescription drug plan underwritten by SilverScript Insurance Company for eligible residents of Florida. The plan is approved by CMS for drug formulary 00012289, which has 2837 FDA approved medications. The monthly premium is $27.60 ($331.20 for a full 12 months) and the pharmacy deductible is $325.00 per year. The highest deductible allowed by CMS for 2013 is $325.

Florida seniors, be aware that a few different circumstances may decrease or increase your actual premium. Specifically, if you qualify for Extra Help (full or partial), your premium will decrease. On the other hand, if you have a premium penalty, your premium will be slightly more.

CVS Caremark Value Initial Coverage Phase

The Initial Coverage Phase (ICP) is your plan’s cost-sharing phase. During the ICP both you and your insurance provider share the cost of your prescription medications. This plan has a deductible, so your ICP does not start until the deductible has been paid.

Each medication is put into a tier within the plan’s formulary. This is simply a way for the insurer to manage cost-sharing. It’s important to note that every plan can put medications on any tier they deem suitable. This is not standardized, because it is based on cost and the various risk models used by the insurers.

The tiered prescription cost sharing (e.g., pharmacy co-pay) in Florida with this plan is as follows:

Tier  Co-Pay AmountMedications in Tier
1$6.001794 Preferred Generics
2$45.00704 Non-Preferred Generics
3$95.0096 Preferred Brand Drugs
425%243 Non-Preferred Brand Drugs
50 Specialty Drugs

The 2012 Initial Coverage Limit with CVS Caremark Value is $2,970.00. This drug plan doesn't qualify for a no cost LIS premium.

Coverage Gap Phase

The Coverage Gap, also known as the Donut Hole is the phase of your Part D plan where you must pay all of your medication costs. Healthcare Reform offers some additional assistance. For 2012 your insurance carrier will pay 7% of your generic drug prescription costs for you while you are in the donut hole. Likewise, the brand-name drug pharmaceutical companies cover half (50%) of your brand-name drug prescription costs. These subsidies count toward your True Out of Pocket (TrOOP) costs.

Some Medicare Part D plans provide additional Coverage Gap assistance that covers you above and beyond the discounts mandated by the Healthcare Reform Act. It’s important to note that if you have prescriptions that are not covered under your plan’s Gap Coverage, you will still get the generic and brand name drug discounts listed above, even if the plan itself does not offer gap coverage.

Here's how the carrier defines the 'donut hole' gap coverage for this policy: You must pay the $3727.50.

Plan Members

The number of Medicare recipients using the CVS Caremark Value plan nationally is 1,333,781. In your area (CMS PDP region 11) there are a reported 169,781 seniors on this plan. That's based on the previous year's reporting information.

Facts About SilverScript Insurance Company

Headquartered in Nashville, TN, SilverScript Insurance Company is a Medicare Prescription Drug Plan that contracts with Medicare and provides prescription drug plans in all 50 states and including the District of Columbia. SilverScript is a subsidiary of CVS Caremark. They offer two prescription drug plans: CVS Caremark Value and CVS Caremark Plus.

Essential Information About Medicare Part D

Pharmacy contracts are different with every drug program. Some programs include strict regional limits, including state borders, while some provide national pharmacy coverage. For those who have an active lifestyle that consists of regular traveling, it's going to assist you to possess a policy that permits you to utilize pharmacies in all states.

Medicare Part D plans use a specified service area. This is basically the area where the provider does business. To sign up, you have to reside in the plan’s service area. Bear in mind that many providers provide mail-order solutions. This way you can have your pharmaceuticals mailed straight to your house. Your representative can help you look for a program that meets your needs, so don’t be reluctant to simply call and inquire.

Each and every healthcare insurance company sets its own rates. Monthly premiums for doctor prescribed drug plans can vary quite a bit, even to get equivalent coverage, so it will pay you to look before you purchase.

Insurance companies publicize new fees and other premium particulars each October. Be sure to take a look at and assess premiums every year in advance of open enrollment.

Please remember if you don't sign up for a Medicare Part D insurance plan when you are eligible, your long term monthly premiums could be higher. This late entry penalty is established by Medicare, not the insurance plan suppliers. Every month you wait following eligibility you will pay an additional 1% each month permanently.