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
Pharmacy agreements will vary with every prescription drug program. Many plans have strict regional limitations, that include state borders, while others give national coverage. Should you have an active lifestyle which often includes frequent traveling, it will assist you to have a policy that permits you to utilize pharmacies in all states.
Medicare Part D plans have got a specified service area. This is the area in which the provider operates. To enroll, you need to live in the plan’s services area. Bear in mind that many carriers provide mail-order support. In this way it's possible to have your pharmaceuticals mailed straight to your home. Your agent can help you find a program that meets your needs, so don’t hesitate to call and inquire.
Each health care insurance supplier establishes their own prices. Prices for doctor prescribed drug plans vary widely, even to get comparable coverage, therefore it will pay you to look prior to choosing.
Insurance companies publicize new prices along with other premium particulars each October. You'll want to check and evaluate premiums annually in advance of open enrollment.
Please remember unless you register for a Medicare Part D insurance policy once you first are eligible, your future monthly premiums could be higher. This late entry penalty is set by Medicare, not the insurance plan providers. Every month you delay following eligibility you'll pay an extra 1% per month permanently.