AARP MedicareRx Preferred, KS 2013 PDP
|Initial Coverage Limit:||$2,970.00|
|Gap Coverage:||No Gap Coverage|
|$0 Premium LIS Benefit:||No|
|Drugs in Formulary:||3614|
|Drug Plan ID:||S5820-023|
|CMS Approved for:||KS Residents|
|Members in Region:||36712|
PDP Plan Highlights
The KS 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 Amount||Medications in Tier|
|1||$4.00||57 Preferred Generics|
|2||$8.00||1226 Non-Preferred Generics|
|3||$39.00||1153 Preferred Brand Drugs|
|4||$95.00||741 Non-Preferred Brand Drugs|
|5||33%||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.
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
Essential Information About Medicare Part D
Pharmacist arrangements will vary with every prescription drug program. Some plans have strict geographic restrictions, including state borders, while some provide you with nationwide coverage. Should you have an active personal life which often consists of frequent traveling, it will help you to have a policy that enables you to use drug stores in all states.
Medicare Part D plans have got a specified service area. It's the area in which the provider operates. To sign up, you have to live in the plan’s provider area. Remember that many providers provide mail-order services. Therefore it's possible to have your medications sent directly to your residence. Your representative will assist you to look for a program that meets your requirements, so don’t be reluctant to simply call and ask.
Each and every medical insurance provider establishes its own prices. Monthly premiums for prescription drug plans vary quite a bit, even for identical coverage, so it will pay you to look prior to choosing.
Insurance providers announce new rates and other premium particulars each October. Do not forget to take a look at and evaluate rates each year prior to open enrollment.
Be aware that if you do not register for a Medicare Part D policy when you are eligible, your long term monthly premiums will probably be higher. This late entry penalty is established by Medicare, not the insurance plan companies. Each month you postpone following eligibility you will pay an extra 1% every month permanently.