AARP MedicareRx Preferred (PDP) New Jersey Medicare Part D Plan S5820-003

AARP MedicareRx Preferred New Jersey Medicare Part D Plan S5820-003-NJAARP MedicareRx Preferred for New Jersey is an approved Medicare Prescription Drug Plan (Part D Plan or PDP) for seniors and other beneficiaries on Medicare living in New Jersey. According to the Centers for Medicare and Medicaid Services (CMS), this plan's quality is "Above Average". Medicare rated it 4.0 out of 5.0 stars.

If you choose to enroll you will pay $54.00 per month (the premium). In addition to the premium there is a $0.00 annual deductible. You can find out more about the costs associated with this plan on the premium page. You also have co-payments when you pickup your prescriptions at the pharmacy. Be sure to look at the coverage page to make sure it fits your needs.

If you have low income subsidy (LIS) benefits, this Medicare Part D plan is not available to you.

Premium Details

Like all Medicare Part D plans sold in New Jersey, AARP MedicareRx Preferred is a cost sharing based prescription drug plan (PDP). If you enroll in the AARP MedicareRx Preferred PDP, you share in the overall costs with the insurer by paying a monthly premium, an annual deductible (if applicable), and copayments at your pharmacy.

The monthly premium is $54.00 ($648.00 paid annually), and the annual deductible is $0.00. A zero dollar ($0.00) deductible means you have first dollar coverage. Many Part D Plans have a deductible (up to $320 per year in 2015) that must be paid before your prescription coverage assistance kicks in.

Be aware that you must continue to pay your monthly premium even when you are not using any medications. Also, it's important to plan ahead because you are responsible for one hundred percent of your prescription costs until the plan's deductible has been met. You also make the required copayment when you pickup your prescriptions. These are your share of the prescription drug costs. The plan pays the rest until you reach the coverage gap (aka, “donut hole”).

There are two situations that can change how much an New Jersey Medicare Part D plan costs you. If your income is low and you are accepted into the Extra Help program administered by Social Security, your premium could be lower. It's also possible that your premium could be higher due to a late entry penalty. Be sure to speak with an authorized New Jersey Medicare Insurance Agent to get an exact quote for your situation.

Coverage Details

AARP MedicareRx Preferred for New Jersey seniors comes with an initial coverage limit (ICL) of $2,960. The deductible on this plan is $0.00 (annual). ICL is calculated based on the full retail cost of prescriptions, not what you or the plan pays. In addition to the premium, you will make co-payments at your pharmacy. Visit the co-pay page to see the co-payment plan.

This PDP has no deductible ($0.00) so your initial coverage phase begins immediately.

AARP MedicareRx Preferred Initial Coverage Limit

It's important to understand the initial coverage limit (ICL) and how it applies to you in New Jersey. The ICL is where you share the cost of your prescriptions with the insurance company. You and the carrier (UnitedHealthcare) each pay your share until you reach a total of $2,960 spent at the pharmacy on prescriptions. At that point you pay all costs yourself because you're in the coverage gap, as explained below.

Medicare Part D Coverage Gap (Donut Hole)

When you fall into the coverage gap, or donut hole as many people call it, you are basically uninsured and must pay for all of your prescription costs out-of-pocket. When you reach the coverage gap will all depend on your prescriptions. Most seniors never exceed the ICL and don't have to worry about it. If you are on a long-term medication that's costly, you could reach the donut hole very quickly.

In the coverage gap phase you are responsible for the full cost of your prescription drugs up until your total out-of-pocket expenses reach $4,550 (excluding premiums and expense paid by insurance) minus a 47.5% discount on brand-name prescription drugs and a 28% discount on generic drugs. Once you reach $4,550 in out-of-pocket expenses, you're out of the coverage gap. At this point you automatically get catastrophic coverage through Medicare, which assures you only pay a small amount for covered drugs for the remainder of the year.

Additional Gap Coverage with AARP MedicareRx Preferred

Some plans offer additional gap coverage. UnitedHealthcare does not offer additional coverage with the AARP MedicareRx Preferred PDP in New Jersey. If you reached the coverage gap last year and were not able to afford your medications, be sure to check with your local New Jersey Medicaid office. You may qualify for additional assistance. The Social Security Administration's Extra Help program is another opportunity for seniors on Medicare who are not able to afford their prescriptions.

Copayment & Coinsurance Details

In addition to the monthly premium and annual deductible, the AARP MedicareRx Preferred prescription drug plan has copayments and/or coinsurances that you must pay when you pickup your medications. Here's the schedule for this plan:

Tier  Co-Pay AmountMedications in Tier
1$2.0063 Preferred Generics
2$5.00698 Non-Preferred Generics
3$35.001120 Preferred Brand Drugs
4$80.001067 Non-Preferred Brand Drugs
533%679 Specialty Drugs

The AARP MedicareRx Preferred Medicare Part D plan uses UnitedHealthcare formulary number 00015002, which covers 3627 generic and brand name drugs.

Compare Plans

Compare this plan with these New Jersey PDPs:


If you are entitled to Medicare Part A (enrolled or not) or currently enrolled in Medicare Part B you may join the AARP MedicareRx Preferred prescription drug plan. Unless you also receive benefits from Medicaid, enrollment in a Part D plan is voluntary. This plan is available in Newark, Jersey City, Camden, Paterson, Elizabeth, Edison, Woodbridge, Lakewood, Toms River, Hamilton, Trenton, Clifton, Cherry Hill, Passaic, Middletown, Union City, Old Bridge, Gloucester City, East Orange, Bayonne, Franklin, North Bergen, Vineland, Union, Piscataway, New Brunswick, Wayne, Irvington, Parsippany and all other towns and cities in New Jersey.

This catalog is maintained by David Bynon and was last updated on 9/14/2015. CMS File Date: October 15, 2014.

About UnitedHealthcare

For more information, download the Summary of Benefits AARP MedicareRx Preferred (PDP) Medicare Part D Plan S5820-003 Summary of Benefits for New Jersey, visit the UnitedHealthcare website, or call UnitedHealthcare at N/A.