Community CCRx Basic PDP for New Hampshire Seniors
| CMS Rating: |  |
|---|---|
| Plan Premium: | $27.20 |
| Pharmacy Co-Pay: | $320.00 |
| Initial Coverage Limit: | $2,930.00 |
| Pharmacy Mail Order: | Yes |
| Gap Coverage: | Few Generics |
| Low Income Subsidy: | Yes |
| Medicare Formulary: | 2893 |
| PDP ID No: | S5803-070 |
| Plan Year: | 2012 |
| Approved by CMS for: | NH Residents |
| Rx Plan Type: | National |
| Members in Region: | 7504 |
2013 Medicare Prescription Drug Plan Overview
NH Community CCRx Basic (PDP) is an approved New Hampshire Medicare Part D Plan. The Community CCRx PDP plan is based on formulary 00012106 with 2893 drugs approved by the FDA. The annual premium is $326.40 ($27.20 monthly), and it carries a $320.00 deductible on all prescribed medications. The maximum deductible for 2012 is $320. This is regulated by CMS.
New Hampshire 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.
Community CCRx Basic 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 Community CCRx Basic (PDP) your pharmacy co-pay in New Hampshire will be tiered as follows:
| Tier | Co-Pay Amount | Medications in Tier |
|---|---|---|
| 1 | $2.00 | 1370 Preferred Generics |
| 2 | 25% | 712 Non-Preferred Generics |
| 3 | 47% | 519 Preferred Brand Drugs |
| 4 | 25% | 292 Non-Preferred Brand Drugs |
| 5 | 0 Specialty Drugs | |
The Initial Coverage Limit (ICL) is $2,930.00. 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: Less than 10% of formulary generics are covered, but you must pay for Brand Drugs up to $3727.50. Use our New Hampshire Medicare donut hole calculator to determine your estimated out-of-pocket precscription drug costs with the Community CCRx Basic (PDP) plan.
Plan Members
Nation wide, the number of seniors using the Community CCRx Basic policy is 1,810,164. In region 1 (your region) there are approximately 7,504 people with this policy (based on 2011 CMS statistics).
More Information About Community CCRx PDP
Endorsed by pharmacy industry leadership, Community Care Rx offers eligible Medicare beneficiaries extensive prescription drug coverage at their local pharmacies. The formulary for the plans goes beyond the US Pharmacopeia- recommended guidelines and covers therapeutic drug classes.
Community Care Rx is 1 of 9 national prescription drug programs approved by the Centers for Medicare and Medicaid Services (CMS) for the Medicare Part D prescription drug plan. Member Health Inc, sponsor of the program, has joined forces with Computer Sciences Corporation and the National Community Pharmacists Association to provide a selection of Medicare Part D products to diverse segments of the Medicare population through Community Care Rx.
The summary (overall) rating for this Community CCRx PDP plan is 3.0 out of 5 based on reviews from 7504 user ratings from the previous year. For more information about the review process, visit http://cms.gov.
