AARP MedicareRx Saver Plus for Indiana is a Medicare Part D prescription drug plan. It's approved by the Centers for Medicare and Medcaid Services (CMS) for people in Indiana with Medicare benefits. CMS gave this plan a quality rating of 3.0 out of 5.0 stars (Average).
The monthly premium is $43.80. It features a $360.00 deductible. There are more cost related details in the premium section on this page. You can see your share at the pharmacy in the co-pay section, or learn more about the coverage in the coverage section.
This is a cost sharing based prescription drug plan (PDP). With the AARP MedicareRx Saver Plus PDP you have several different costs, including the premium (monthly), a deductible (annual), and pharmacy co-pays and/or co-insurance.
The monthly premium is $43.80 ($525.60 paid annually). It breaks down as follows:
This plan is not available to people receiving low income subsidy (LIS) benefits.
The annual deductible is $360.00. For 2016, the maximum Part D deductible is $360. A plan with the maximum deductible does not necessarily mean that it is more expensive than a plan with a lower deductible or no deductible at all. You need to consider all costs.
You Pay the Premium + Deductible + Copayments
Here's a rundown of your shared costs. Like all other types of insurance, you must pay your premium. The premium has nothing to do with how many prescriptions you have filled. If the plan has a deductible, you must pay one hundred percent of your prescription costs until you reach the amount of the deductible. When the deductible is met, then you pay the copayment amount at the pharmacy. All other costs are paid by the plan until you hit the donut hole (initial coverage limit)
What You Pay Could Be Different
Most people pay the standard premium. However, if you qualify for Extra Help with your Medicare Part D plan due to your income, your premium may be lower or cost you nothing at all. But, if you did not enroll in a Part D plan as soon as you were first eligible, Medicare can impose a penalty and your premium will be higher. To get an exact rate for your situation, contact a Indiana Medicare Insurance Agent.
AARP MedicareRx Saver Plus is a Actuarially Equivalent Standard PDP. At a minimum, UnitedHealthcare must offer a "standard benefit" package mandated by law. The standard benefit includes an annual deductible and a gap in coverage, aka, donut hole. Carriers may also offer plans that:
- are actuarially equivalent to the standard benefit; or
- are enhanced, offering benefits in addition to the standard benefit.
Typically, enhanced plans offer additional coverage during the coverage gap. If you fell into the donut hole last year, shop enhanced plans.
Initial Coverage Limit
Confused about the initial coverage limit? Don't be, because it's straight forward. If you enroll in the AARP MedicareRx Saver Plus PDP, you share the cost of your prescriptions with UnitedHealthcare. You each pay your share until the amount spent at the pharmacy reaches $3310.00. That's the initial coverage limit in Indiana for plan year 2016. After that you are not covered (coverage gap) until your actual out-of-pocket costs qualify you for catastrophic coverage. Keep reading, because you are entitled to automatic discounts.
Coverage Gap (aka, Donut Hole)
The coverage gap, or donut hole, as it is often called, is the coverage phase where you no longer receive assistance from the plan. In other words, you pay for your prescriptions out-of-pocket. How quickly you reach the coverage gap with AARP MedicareRx Saver Plus all depends on your prescriptions. Most seniors never fall into the donut hole.
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
AARP MedicareRx Saver Plus does not offer additional assistance in the coverage gap. If you reached the coverage gap last year and were not able to afford your medications, be sure to check with your local Indiana 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 Saver Plus prescription drug plan has copayments (fixed dollar amount) and/or coinsurances (percentage) that you must pay when you pickup your medications. Here's the schedule for this plan:
|Tier||You Pay||Medications in Tier|
|3||$17.00||Preferred Brand Drugs|
|4||30%||Non-Preferred Brand Drugs|
IMPORTANT: In order to determine if this is the best PDP for you, it's critical that you lookup your prescriptions in the plan's formulary.
AARP MedicareRx Saver Plus has an overall rating of 3.0 out of 5 stars. This summary rating was assigned by the Centers for Medicare and Medicaid Services (CMS) based on the plan's previous year performance. It provides shoppers with an overall score on the drug plan's quality and performance across 3 broad categories:
- Drug plan customer service (5.0 stars): Includes handling of member appeals.
- Member experience with the plan's drug services (3.0 stars): Includes ratings of member satisfaction with the plan.
- Drug safety and accuracy of drug pricing (2.0 stars): Includes how accurate the plan's pricing information is and how often members with certain medical conditions are prescribed drugs in a way that is considered safer and clinically recommended for their condition.
CMS gathers quality information from several sources, including member surveys, reviews of billing and other information that plans submit to Medicare, and other monitoring activities.
If you are entitled to Medicare Part A (enrolled or not) or currently enrolled in Medicare Part B you may join the AARP MedicareRx Saver Plus prescription drug plan. Unless you also receive benefits from Medicaid, enrollment in a Part D plan is voluntary. This plan is available in Fort Wayne, Evansville, South Bend, Noblesville, Bloomington, Fishers, Hammond, Gary, Muncie, Lafayette, Terre Haute, Greenwood, Elkhart, Indianapolis, Carmel, Anderson, and all other towns and cities in Indiana.
This PDP information is maintained by David Bynon and was last updated on .