WellCare Extra, CA 2013 PDP

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Summary Rating:This Medicare drug plan has an average rating of 0.0
Premium:
$49.00
Deductible:$0.00
Initial Coverage Limit:$2,970.00
Mail Order:No
Gap Coverage:Many Generics
$0 Premium LIS Benefit:No
Drugs in Formulary:0
Drug Plan ID:S5967-203
Plan Year:2013
CMS Approved for:CA Residents
Plan Type:National
Members in Region:0

PDP Plan Highlights

Active California Senior, Medicare Part D Plan: WellCare Extra (PDP) S5967-203CA WellCare Extra (PDP) is a Medicare prescription drug plan underwritten by WellCare for eligible residents of California. The plan is approved by CMS for drug formulary UNKNOWN, which has 0 FDA approved medications. The monthly premium is $49.00 ($588.00 for a full 12 months) and the pharmacy deductible is $0.00 per year. That means you receive prescription coverage assistance on day one (first dollar coverage).

California 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.

WellCare Extra 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.

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

Tier  Co-Pay AmountMedications in Tier
10 Preferred Generics
20 Non-Preferred Generics
30 Preferred Brand Drugs
40 Non-Preferred Brand Drugs
50 Specialty Drugs

The 2012 Initial Coverage Limit with WellCare Extra is $2,970.00. This drug plan doesn't qualify for a no cost 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.

Here's how the carrier defines the 'donut hole' gap coverage for this policy: 65% to 100% of formulary generics are covered, but you must pay for Brand Drugs up to $3727.50.

Plan Members

The number of Medicare recipients using the WellCare Extra plan nationally is 0. In your area (CMS PDP region 32) there are a reported 0 seniors on this plan. That's based on the previous year's reporting information.

Facts About WellCare

WellCare Health Plans, Inc. provides managed care services targeted to government-sponsored health care programs, focusing on Medicaid and Medicare. Headquartered in Tampa, Florida, WellCare offers a variety of health plans for families; children; and the aged, blind and disabled; as well as prescription drug plans. The company served approximately 2.4 million members nationwide as of June 30, 2011.

Essential Information About Medicare Part D

Drugstore contracts are unique with each drug plan. Many plans have stringent geographic limits, that include state borders, while others provide nationwide drugstore coverage. If you have an active lifestyle that consists of regular traveling, it may assist you to possess a policy that enables you to utilize drug stores in all states.

Medicare Part D plans use a specified service area. This is the area where the provider does business. To enroll, you must live in the plan’s provider area. Be aware that many providers offer mail-order services. This way you could have your medications mailed directly to your house. Your representative can assist you to look for a plan that meets your needs, so don’t hesitate to call and inquire.

Each health insurance provider establishes its own rates. Monthly premiums pertaining to approved drug plans vary quite a bit, even to get equivalent coverage, as a result it pays to look before you choose.

Insurance companies publicize new fees along with other premium information each October. Make sure to check and compare premiums each year just before open enrollment.

Be aware that if you don't register for a Medicare Part D insurance plan as soon as you are eligible, your future monthly premiums will probably be higher. This late entry consequence is established by Medicare, not the insurance suppliers. Every month you delay following eligibility you will pay an additional 1% each month forever.