AARP MedicareRx Preferred, KS 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: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 agreements are unique with every drug plan. Some plans have stringent geographic restrictions, such as state borders, whilst some supply national drugstore coverage. If you have an active personal life that includes regular traveling, it's going to assist you to have a policy that allows you to use pharmacies in all states.

Medicare Part D plans use a designated service area. This is basically the area in which the provider operates. To enroll, you need to reside in the plan’s services area. Be aware that nearly all providers provide mail-order solutions. In this way it's possible to have your prescription medications mailed directly to your home. Your agent will assist you to look for a plan that suits what you need, so don’t be reluctant to phone and ask.

Each health insurance company establishes its own rates. Payments for approved drug plans vary widely, even for comparable coverage, as a result it will pay you to look prior to choosing.

Insurance companies publicize new fees and other premium information each October. Be sure to check and assess rates each year just before open enrollment.

Be aware that unless you sign up for a Medicare Part D insurance plan when you are eligible, your long term rates will likely be higher. This late entry penalty is established by Medicare, not the insurance plan companies. Each month you delay after eligibility you will pay an additional 1% every month forever.