AARP MedicareRx Saver Plus, SC 2013 PDP
|Initial Coverage Limit:||$2,970.00|
|Gap Coverage:||No Gap Coverage|
|$0 Premium LIS Benefit:||Yes|
|Drugs in Formulary:||0|
|Drug Plan ID:||S5921-354|
|CMS Approved for:||SC Residents|
|Members in Region:||0|
PDP Plan Highlights
SC AARP MedicareRx Saver Plus (PDP) is an approved South Carolina Medicare Part D Plan. The UnitedHealthcare plan is based on formulary UNKNOWN with 0 drugs approved by the FDA. The annual premium is $180.00 ($15.00 monthly), and it carries a $325.00 deductible on all prescribed medications. The maximum deductible for 2013 is $325. This is regulated by CMS.
South Carolina seniors, several factors may increase or decrease this premium. For example, if you qualify for full or partial Extra Help, your premium could be lower. If you have a premium penalty (for late entry), your premium will be higher.
AARP MedicareRx Saver Plus 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.
If you choose AARP MedicareRx Saver Plus (PDP) your pharmacy co-pay in South Carolina will be tiered as follows:
|Tier||Co-Pay Amount||Medications in Tier|
|1||0 Preferred Generics|
|2||0 Non-Preferred Generics|
|3||0 Preferred Brand Drugs|
|4||0 Non-Preferred Brand Drugs|
|5||0 Specialty Drugs|
The Initial Coverage Limit (ICL) is $2,970.00. This policy does qualify for the full LIS benefit ($0.00 monthly 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 Gap Coverage with this policy: You must pay the $3727.50.
Nation wide, the number of seniors using the AARP MedicareRx Saver Plus policy is 0. In region 9 (your region) there are approximately 0 people with this policy (based on 2011 CMS statistics).
Facts About UnitedHealthcare
United Healthcare is an operating division of UnitedHealth Group, the largest single health carrier in the United States. UnitedHealth Group is a diversified managed health care company headquartered in Minnetonka, Minnesota, USA. They offer a spectrum of products and services through two operating businesses: United Healthcare and Optum.
Through its family of subsidiaries and divisions, UnitedHealth Group serves approximately 70 million individuals nationwide. In 2010, the company posted a net income of $4.6 billion.
Essential Information About Medicare Part D
Pharmacy agreements are unique with every prescription drug program. Certain programs contain strict geographic limits, including state borders, while some provide national coverage. Should you have an active personal life that consists of frequent traveling, it may help you to have a policy that enables you to use drug stores in all states.
Medicare Part D plans have a specified service area. It's the area where the provider does business. To sign up, you have to live in the plan’s services area. Remember that many carriers provide mail-order services. This way you could have your medications shipped directly to your residence. Your agent can help you find a program that meets your needs, so don’t be reluctant to phone and ask.
Each health insurance company establishes its own prices. Monthly premiums for approved drug plans vary widely, even for equivalent coverage, therefore it pays to shop prior to choosing.
Insurance providers publicize new rates as well as other premium details each October. Be sure to check and evaluate 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 future payments will likely be higher. This late entry penalty is set by Medicare, not the insurance plan companies. Each month you delay following eligibility you will pay an additional 1% each month forever.