On this page we help consumers: Compare WellCare Value Script, a 2019 Michigan Medicare Part D Plan (Premium: $15.00/mo, Deductible: $415.00/yr) with all Prescription Drug Plans in MI. This plan is approved by the Centers for Medicare and Medicaid Services (CMS) for people in Michigan with Medicare benefits.
CMS gave this plan a quality rating of 3.0 out of 5.0 stars (Average).
These are the areas of the plan that are important to compare and review:
- Premium & Deductible: The premium is the amount you will pay monthly. Plud, many plans have an annual deductible that must be met before cost sharing begins.
- Coverage Phases: Part D plans have an initial coverage limit, followed by a coverage gap, and then catastropic coverage. Some plans offer some coverage in the gap.
- Co-pays & Co-insurance: If you have regular prescriptions, it's critical to verify that your drugs are covered and to know what you will pay at the pharmacy.
- CMS Ratings: Important measurements across 4 different areas that will help you understand how well this plan will care for you.
This is a cost sharing based prescription drug plan (PDP). With the WellCare Value Script 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 $15.00 ($180.00 paid annually). It breaks down as follows:
This plan is not available to people receiving low income subsidy (LIS) benefits.
The annual deductible is $415.00.
For 2019, the maximum Part D deductible in is $415. 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
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”).
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 Michigan Medicare Insurance Agent.
WellCare Value Script is a Enhanced PDP. At a minimum, WellCare 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
The ICL is the same for all Michigan plans, but it changes from year-to-year. If you enroll in WellCare Value Script you share the cost of all covered medications with WellCare. You each pay your share until $3820.00 (retail spending) has been spent at the pharmacy. If you reach that level of spending on your prescriptions then you fall into the dreaded coverage gap and you are responsible for all costs. Fortunately, automatic discounts kick in to help you until you qualify for Medicare's catastrophic coverage in Michigan.
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 WellCare Value Script all depends on your prescriptions. Most seniors never fall into the donut hole.
If you reach the ICL (most seniors don't), then you are responsible for 100% of your prescription costs until your out-of-pocket costs hit $4,550 (excluding your monthly premiums and the amount paid by the plan). This is called the coverage gap or donut hole. The good news is that you get a 47.5% discount on brand-name prescription drugs and a 28% discount on generic drugs while you're in the gap. You get to the other side of the donut hole when you've spent $4,550, at which point you automatically qualify to receive catastrophic coverage from Medicare.
Additional Gap Coverage
WellCare Value Script 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 Michigan 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 WellCare Value Script 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:
|1 (Preferred Generic)||$0.00 copay||$3.00 copay|
|2 (Generic)||$6.00 copay||$9.00 copay|
|3 (Preferred Brand)||$40.00 copay||$47.00 copay|
|4 (Non-Preferred Drug)||46%||50%|
|5 (Specialty Tier)||25%||25%|
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.
Medicare Part D Star Ratings
In this section we show you the quality rating for this plan. Each year the Centers for Medicare and Medicaid Services (CMS) rates prescription drug plans in four broad categories. We do not recommend joining a plan with an overall rating less than 3.0. The following marks will give you an idea of the level of care you will receive if you join this WellCare plan.
Here's the new member contact information for WellCare:
For assistance 24 hours a day, call 800-633-4227. TTY users should call 877-486-2048. If you qualify for Medicare but have not yet enrolled or verified your enrollment status, you can do so on the Social Security Administration website. You can learn more about the Medicare Part D program on www.medicare.gov or the Wikipedia page. For information about the SSA's Extra Help program, download the Understanding Extra Help guide.
2020 Part D Plan Information
If you are entitled to Medicare Part A (enrolled or not) or currently enrolled in Medicare Part B you may join the WellCare Value Script prescription drug plan. Unless you also receive benefits from Medicaid, enrollment in a Part D plan is voluntary. This plan is available in Detroit, Warren, Dearborn, Grand Rapids, Flint, Lansing, Sterling Heights, Ann Arbor, Livonia, Dearborn, Clinton, Westland, Kalamazoo, Southfield, Troy, Pontiac, Taylor, Saginaw, Saint Clair Shores, Waterford, Royal Oak, Wyoming, Dearborn Heights, and all other towns and cities in Michigan.
The Medicare Part D plan data on MedicareWire.com originates from CMS.gov Landscape Source files and is subject to change. The Centers for Medicare and Medicaid Services has neither reviewed nor endorsed the information on this site.
The benefit information provided on this page is a brief summary only, not a complete description. Limitations, co-payments, and restrictions may apply. For more information contact the plan directly at (888)900-4307 or (888)816-5252 for TTY users.
You must live in the service area and be enrolled in Medicare Part A and/or Medicare Part B in order to enroll in a Medicare Part D plan.
You must use network pharmacies to access drug benefit, except in non-routine circumstances. Restrictions may apply.
Benefits, formulary, pharmacy network, premium, and/or co-payments/co-insurance may change January 1, of each year.
This page presents an independent review of WellCare as a Medicare Part D plan insurance carrier in Michigan. MedicareWire provides this information for consumer educational purposes. Our goal is to present information accurately and without bias, based on our interpretation of factual information about each carrier. MedicareWire is not a substitute for legal, health, or financial advice from a licensed professional.
The WellCare logo and name are legal U.S. trademarks of WellCare. All trademarks remain the property of their owner and are used by MedicareWire only to review, editorialize and describe the products and services offered by WellCare (the trademark holder). We make no claim to the marks whatsoever.
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This PDP information on this page is maintained by David Bynon and was last updated on .