AARP MedicareRx Preferred, KS 2013 PDP

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Summary Rating:This Medicare drug plan has an average rating of 3.0
Premium:
$42.60
Deductible:$0.00
Initial Coverage Limit:$2,970.00
Mail Order:Yes
Gap Coverage:No Gap Coverage
$0 Premium LIS Benefit:No
Drugs in Formulary:3614
Drug Plan ID:S5820-023
Plan Year:2013
CMS Approved for:KS Residents
Plan Type:National
Members in Region:36712

PDP Plan Highlights

The American Senior, Medicare Part D Plan: AARP MedicareRx Preferred (PDP) S5820-023KS AARP MedicareRx Preferred (PDP) Medicare Part D prescription drug plan is covered by UnitedHealthcare for Kansas seniors and other qualifying residents. The plan is approved by CMS for drug formulary 00012261, which has 3614 FDA approved medications. The plan's premium is $42.60 per month ($511.20 annually) and it has a $0.00 annual pharmacy deductible. That means prescription coverage assistance starts on day one. You simply make your co-payment at the pharmacy.

Kansas seniors, there are a few circumstances that can affect your premium. Beneficiaries that qualify for Extra Help will have a lower premium. Beneficiaries with a penalty will have a premium that is slightly higher.

AARP MedicareRx Preferred 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 no deductible so your initial coverage phase begins immediately.

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.

In Kansas the tiered prescription cost sharing (e.g., pharmacy co-pay) with AARP MedicareRx Preferred (PDP) is as follows:

Tier  Co-Pay AmountMedications in Tier
1$4.0057 Preferred Generics
2$8.001226 Non-Preferred Generics
3$39.001153 Preferred Brand Drugs
4$95.00741 Non-Preferred Brand Drugs
533%437 Specialty Drugs

The ICL (Initial Coverage Limit) on this Medicare Part D plan is $2,970.00. This plan doesn't qualify for a $0 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.

The 'donut hole' gap coverage on this policy is: You must pay the $3727.50.

Plan Members

The number of Medicare recipients using the AARP MedicareRx Preferred plan nationally is 4,032,058. In your CMS region (PDP region 24) there are an estimated 36,712 people using the plan (previous year's statistics).

Facts About UnitedHealthcare

For over 20 years, UnitedHealthcare and its affiliates have offered Medicare plans to people age 65 or older, as well as individuals with certain disabilities. Today UnitedHealthcare offers a full range of Medicare options, including:

  • Medicare Advantage Insurance and HMO Health Plans
  • Medicare Supplement Insurance Plans
  • Medicare Part D Prescription Drug Insurance Plans
  • Medicare Advantage Special Needs Plans
UnitedHealthcare also offers health programs for beneficiaries of Medicaid. This program provides medical assistance for low income individuals and families who meet federal or state eligibility requirements.

Essential Information About Medicare Part D

Pharmacy arrangements are different with every prescription drug program. Many programs have strict geographic restrictions, including state borders, while others provide you with national drugstore coverage. If you have an active lifestyle which includes frequent traveling, it may benefit you to have a policy that permits you to utilize pharmacies in all states.

Medicare Part D plans use a specified service area. It's the area where the provider operates. To enroll, you must reside in the plan’s provider area. Be aware that nearly all providers offer mail-order support. Therefore you could have your medications sent directly to your house. Your advisor can assist you to find a program that suits what you need, so don’t be reluctant to call and ask.

Each and every health insurance supplier sets their own rates. Payments pertaining to approved drug plans can vary widely, even to get equivalent coverage, so it pays to look before you purchase.

Insurance companies announce new prices and other premium particulars each October. Do not forget to check and assess premiums each year in advance of open enrollment.

Bear in mind that if you do not register for a Medicare Part D insurance plan once you first are eligible, your long term rates will probably be higher. This late entry penalty is established by Medicare, not the insurance companies. Each month you delay subsequent to eligibility you'll pay an additional 1% per month permanently.