WellCare Extra PDP for Michigan Seniors
|Initial Coverage Limit:||$2,850.00|
|Pharmacy Mail Order:||Yes|
|Gap Coverage:||No Gap Coverage|
|Low Income Subsidy:||No|
|PDP ID No:||S5967-185|
|Approved by CMS for:||MI Residents|
|Rx Plan Type:||Regional|
2014 Medicare Prescription Drug Plan Overview
WellCare Extra (PDP) is an approved Medicare Part D Drug Plan underwritten by WellCare for eligible Michigan seniors with Medicare benefits.
The monthly premium is $44.60 ($535.20 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).
The plan is based on drug formulary ID 00014172. The formulary offers 2844 FDA approved medications. Be sure to verify that your medications are covered.
Michigan 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 WellCare Extra plan compares well with these plans:
- Express Scripts Medicare - Choice at $65.90 per month for Michigan Seniors
- Prescription Blue Option B at $98.30 per month for Michigan Seniors
- Transamerica MedicareRx Choice at $51.50 per month for Michigan Seniors
WellCare Extra 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 2014, the ICL is $2,850. This number is adjusted each year. This plan has no deductible so your initial coverage phase begins immediately.
All prescription drugs fall into one of several tiers within the insurance carrier's drug formulary. Carriers 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 Michigan the pharmacy co-pay for prescription drugs is as follows:
|Tier||Co-Pay Amount||Medications in Tier|
|1||$0.00||281 Preferred Generics|
|2||$0.00||1576 Non-Preferred Generics|
|3||$38.00||264 Preferred Brand Drugs|
|4||$73.00||403 Non-Preferred Brand Drugs|
|5||33%||320 Specialty Drugs|
The Initial Coverage Limit with WellCare Extra is $2,850.00. This plan does not qualify for a no cost LIS premium.
WellCare Extra (PDP) 2014 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 WellCare Extra (PDP) plan all depends on your prescriptions.
Here's how the carrier defines the 'donut hole' gap coverage for this policy: No Gap Coverage
WellCare Extra Plan Members
The number of seniors using the WellCare Extra plan nationally is 0. In your area (PDP region 13) there are a reported 0 seniors using this pharmacy plan. That's based on the previous year's CMS information.
Related Medicare Benefits in MI
More Information About WellCare
WellCare Health Plans, Inc. provides managed care services targeted to government-sponsored health care programs, focusing on Medicaid and Medicare. Headquartered in Tampa, Florida, WellCare offers a variety of health plans for families; children; and the aged, blind and disabled; as well as prescription drug plans. The company served approximately 2.4 million members nationwide as of June 30, 2011.
The summary (overall) rating for this WellCare plan is 3.0 out of 5 based on reviews from 0 user ratings from the previous year. For more information about the review process, visit http://cms.gov.