Community CCRx Choice PDP for New Hampshire Seniors
| CMS Rating: |  |
|---|---|
| Plan Premium: | $90.10 |
| Pharmacy Co-Pay: | $0.00 |
| Initial Coverage Limit: | $2,930.00 |
| Pharmacy Mail Order: | Yes |
| Gap Coverage: | Few Generics |
| Low Income Subsidy: | No |
| Medicare Formulary: | 2893 |
| PDP ID No: | S5803-138 |
| Plan Year: | 2012 |
| Approved by CMS for: | NH Residents |
| Rx Plan Type: | National |
| Members in Region: | 364 |
2013 Medicare Prescription Drug Plan Overview
NH Community CCRx Choice (PDP) is a Medicare prescription drug plan underwritten by Community CCRx PDP for eligible residents of New Hampshire. The plan is approved by CMS for drug formulary 00012106, which has 2893 FDA approved medications. The monthly premium is $90.10 ($1,081.20 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).
New Hampshire 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.
Community CCRx Choice 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 New Hampshire with this plan is as follows:
| Tier | Co-Pay Amount | Medications in Tier |
|---|---|---|
| 1 | $0.00 | 1370 Preferred Generics |
| 2 | $40.00 | 712 Non-Preferred Generics |
| 3 | $70.00 | 519 Preferred Brand Drugs |
| 4 | 33% | 292 Non-Preferred Brand Drugs |
| 5 | 0 Specialty Drugs | |
The 2012 Initial Coverage Limit with Community CCRx Choice is $2,930.00. 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: Less than 10% of formulary generics are covered, but you must pay for Brand Drugs up to $3727.50. Use our free New Hampshire donut hole calculator to estimate out-of-pocket expenses for your precscription drugs with this policy.
Plan Members
The number of Medicare recipients using the Community CCRx Choice plan nationally is 122,705. In your area (CMS PDP region 1) there are a reported 364 seniors on this plan. That's based on the previous year's reporting information.
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 364 user ratings from the previous year. For more information about the review process, visit http://cms.gov.
