Medco Medicare Prescription Plan - Value PDP for Maine Seniors
| CMS Rating: |  |
|---|---|
| Plan Premium: | $49.10 |
| Pharmacy Co-Pay: | $325.00 |
| Initial Coverage Limit: | $2,970.00 |
| Pharmacy Mail Order: | Yes |
| Gap Coverage: | No Gap Coverage |
| Low Income Subsidy: | No |
| Medicare Formulary: | 3178 |
| PDP ID No: | S5660-104 |
| Plan Year: | 2013 |
| Approved by CMS for: | ME Residents |
| Rx Plan Type: | National |
| Members in Region: | 329 |
2013 Medicare Prescription Drug Plan Overview
Medco Medicare Prescription - Value (PDP) is an approved Medicare Part D Drug Plan underwritten by Medco for eligible Maine seniors with Medicare benefits.
The monthly premium is $49.10 ($589.20 for a full 12 months) and the pharmacy deductible is $325.00 per year. The highest deductible allowed in 2013 is $325.
The plan is based on drug formulary ID 00012031. The formulary offers 3178 FDA approved medications. Be sure to verify that your medications are covered.
Maine 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.
The Medco Medicare Prescription Plan - Value plan compares well with these plans:
- WellCare Classic at $33.50 per month for Maine Seniors
- Humana Walmart-Preferred Rx Plan at $18.50 per month for Maine Seniors
- AARP MedicareRx Preferred at $35.10 per month for Maine Seniors
Medco Medicare Prescription Plan - Value Initial Coverage
ICP - the Initial Coverage Phase - is where you share the cost of your prescriptions with your insurance company. You and the carrier each pay your share until you hit the Initial Coverage Limit (ICL). In 2013, the ICL is $2,970. This number is adjusted each year. This plan has a deductible, so your ICP does not start until the deductible has been paid.
All prescription drugs fall into one of several tiers within the insurance carrier's drug formulary. Carrier use the formulary tiers to manage cost-sharing. Be aware that tiers are not standardized. In other words, carriers assign drugs to the tier they deem most suitable.
In Maine the pharmacy co-pay for prescription drugs is as follows:
| Tier | Co-Pay Amount | Medications in Tier |
|---|---|---|
| 1 | $4.00 | 537 Preferred Generics |
| 2 | $8.00 | 1271 Non-Preferred Generics |
| 3 | 25% | 1012 Preferred Brand Drugs |
| 4 | 40% | 162 Non-Preferred Brand Drugs |
| 5 | 25% | 196 Specialty Drugs |
The Initial Coverage Limit with Medco Medicare Prescription Plan - Value is $2,970.00. This plan does not qualify for a no cost LIS premium.
Medco Medicare Prescription - Value (PDP) 2013 Coverage Gap
The prescription drug Coverage Gap (aka, "Donut Hole") is the coverage phase where you must pay all of your medication costs. You can learn more about costs in the donut hole by reading What is the Medicare Part D Donut Hole? When you reach the donut hole with the Medco Medicare Prescription - Value (PDP) plan all depends on your prescriptions.
Here's how the carrier defines the 'donut hole' gap coverage for this policy: You must pay the $3727.50.
Medco Medicare Prescription Plan - Value Plan Members
The number of seniors using the Medco Medicare Prescription Plan - Value plan nationally is 435,331. In your area (PDP region 1) there are a reported 329 seniors using this pharmacy plan. That's based on the previous year's CMS information.
Related Medicare Benefits in ME
More Information About Medco
Medco Medicare Prescription Plan is a Medicare-approved Part D sponsor that is offered nationally in 35 Medicare regions, including the District of Columbia and Puerto Rico. This prescription drug plan is underwritten by Medco Containment Insurance Company of New York, an insurance company licensed in New York, and Medco Containment Life Insurance Company, an insurance company licensed or authorized to do business in the states that comprise the other 34 Medicare regions.The summary (overall) rating for this Medco plan is 4.0 out of 5 based on reviews from 329 user ratings from the previous year. For more information about the review process, visit http://cms.gov.
