HealthSpring Prescription Drug Plan -Reg 9, SC 2013 PDP

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Summary Rating:This Medicare drug plan has an average rating of 2.5
Initial Coverage Limit:$2,970.00
Mail Order:Yes
Gap Coverage:No Gap Coverage
$0 Premium LIS Benefit:Yes
Drugs in Formulary:2989
Drug Plan ID:S5932-009
Plan Year:2013
CMS Approved for:SC Residents
Plan Type:National
Members in Region:13761

PDP Plan Highlights

Active South Carolina Senior, Medicare Part D Plan: HealthSpring Prescription Drug Plan -Reg 9 (PDP) S5932-009SC HealthSpring Prescription Drug -Reg 9 (PDP) is a Medicare prescription drug plan underwritten by HealthSpring Prescription Drug Plan for eligible residents of South Carolina. The plan is approved by CMS for drug formulary 00012352, which has 2989 FDA approved medications. The monthly premium is $39.20 ($470.40 for a full 12 months) and the pharmacy deductible is $325.00 per year. The highest deductible allowed by CMS for 2013 is $325.

South Carolina seniors, be aware that a few different circumstances may decrease or increase your actual premium. Specifically, if you qualify for Extra Help (full or partial), your premium will decrease. On the other hand, if you have a premium penalty, your premium will be slightly more.

HealthSpring Prescription Drug Plan -Reg 9 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.

The tiered prescription cost sharing (e.g., pharmacy co-pay) in South Carolina with this plan is as follows:

Tier  Co-Pay AmountMedications in Tier
125%1984 Preferred Generics
225%1005 Non-Preferred Generics
30 Preferred Brand Drugs
40 Non-Preferred Brand Drugs
50 Specialty Drugs

The 2012 Initial Coverage Limit with HealthSpring Prescription Drug Plan -Reg 9 is $2,970.00. This drug plan qualifies for the full LIS benefit and a zero dollar 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.

Here's how the carrier defines the 'donut hole' gap coverage for this policy: You must pay the $3727.50.

Plan Members

The number of Medicare recipients using the HealthSpring Prescription Drug Plan -Reg 9 plan nationally is 466,785. In your area (CMS PDP region 9) there are a reported 13,761 seniors on this plan. That's based on the previous year's reporting information.

Facts About HealthSpring Prescription Drug Plan

Based in Nashville, Tennessee, HealthSpring got its start in 2000 and is now one of the country’s largest and fastest-growing coordinated care plans whose primary focus is Medicare Advantage plans. HealthSpring currently owns and operates Medicare Advantage plans in Alabama, Delaware, Florida, Georgia, Illinois, Maryland, Mississippi, New Jersey, Pennsylvania, Tennessee, Texas, and Washington, D.C., as well as a national stand-alone prescription drug plan.

Essential Information About Medicare Part D

Drugstore arrangements are unique with each prescription drug program. Some plans include strict geographic limitations, such as state boundaries, while some provide national drugstore coverage. Should you have an active life which often consists of frequent traveling, it's going to assist you to possess a policy that allows you to use drug stores in all states.

Medicare Part D plans have a designated service area. This is basically the area in which the provider operates. To sign up, you will need to live in the plan’s provider area. Be aware that nearly all providers offer mail-order services. This way it's possible to have your medications mailed straight to your house. Your agent can help you look for a program that suits your needs, so don’t hesitate to simply call and ask.

Each healthcare insurance company establishes its own prices. Payments pertaining to prescription drug plans vary widely, even to get comparable coverage, so it pays to look prior to choosing.

Insurance providers announce new rates as well as other premium particulars each October. You'll want to take a look at and evaluate premiums annually in advance of open enrollment.

Please remember unless you sign up for a Medicare Part D insurance plan when you first are eligible, your long term payments could be higher. This late entry penalty is set by Medicare, not the insurance plan providers. Every month you wait after eligibility you'll pay an extra 1% per month forever.