Wellcare Value Script (Enhanced PDP) A 2023 Massachusetts Medicare Part D Plan Review
Wellcare Value Script is a 2023 Enhanced Medicare Part DMedicare Part D plans are an option Medicare beneficiaries can use to get prescription drug coverage. Part D plans provide cost-sharing on covered medications in four different phases: deductible, initial coverage, coverage gap, and catastrophic. Each... plan (S4802-137) from WellCare that's available to people with Medicare Part A and/or Part B, or a Medicare Advantage plan that does not include prescription benefits, in Massachusetts.
This is a cost-sharing plan that has an initial coverage limitOnce you have met your yearly deductible, you will pay a copayment or coinsurance for each covered drug until you reach the initial coverage limit. You will then enter your plan’s coverage gap (aka, “donut... of $4,660 and a $505.00 annual deductibleA deductible is an amount a beneficiary must pay for their health care expenses before the health insurance policy begins to pay its share.. This plan is rated 3.0 (Average) stars by CMS.
Key Takeaways
- This is an enhanced benefit Medicare Part D plan from WellCare.
- Enhanced benefit plans, like Wellcare Value Script, have a higher actuarial value than basic benefit plans.
- Actuarial value simply refers to the percentage of cost covered by Wellcare Value Script.
- The premiumA premium is an amount that an insurance policyholder must pay for coverage. Premiums are typically paid on a monthly basis. In the federal Medicare program, there are four different types of premiums. is $8.60 per month. You pay this amount even if you don't have regular prescriptions.
- The deductible is $505.00 per year.
- This plan does not offer additional coverage in the donut hole (coverage gapA period of time in which you pay higher cost-sharing for prescription drugs until you spend enough to qualify for catastrophic coverage.).
- This plan does not qualify for the Extra Help program's full low-income subsidySocial Security's Low-Income Subsidy (LIS) program helps Medicare beneficiaries pay for their Medicare Part D prescription drugs by paying some of the costs. Also known as "Extra Help", beneficiaries who qualify for LIS receive premium....
- Costs can vary significantly between plans. If you have regular prescriptions it is important to compare costs carefully before you enroll.
| Plan Basics | |
|---|---|
| Plan ID: | S4802-137 |
| Plan Type: | PDP |
| Plan Year: | 2023 |
| Premium: | $8.60/mo |
| Deductible: | $505.00/yr |
| Benefit Type: | Enhanced |
| Rx Gap Coverage: | No |
| Low Income Subsidy: | No |
| Availability: | Massachusetts |
| Insured By: | WellCare |
WARNING: Before enrolling in this or any other Medicare Part D plan, it is very important to understand what your costs will be for your regular prescriptions.
Prescription Drug Plan Premium
Although Wellcare Value Script's monthly premium is bundled with the total plan cost, some plans have supplemental costs and/or offer low-income subsidy (LIS) assistance. The following table outlines the premium details of this WellCare plan.
| Basic Part D Premium: | -$30.80 |
| Supplemental Part D Premium: | $39.40 |
| Total Part D Premium: | $8.60 |
| Part D Premium with Full LIS Assistance: | $8.60 |
| Part D Premium with 75% LIS Assistance: | $8.60 |
| Part D Premium with 50% LIS Assistance: | $8.60 |
| Part D Premium with 25% LIS Assistance: | $8.60 |
For more information about the Low-Income Subsidy (aka, "Extra Help") program, refer to the Social Security Extra Help page.
Prescription Drug Plan Deductible
The Medicare Part D annual deductible with this plan is $505.00. This is the amount you must pay at the pharmacy before WellCare begins paying its share.
NOTE: The deductible does not apply to one or more drug tiers in this plan (see "Prescription Drug Plan Out-of-Pocket Costs" below).
Prescription Drug Plan Out-of-Pocket Costs
In addition to the plan's monthly premium and deductible, Wellcare Value Script has copaymentsA copayment, also known as a copay, is a set dollar amount you are required to pay for a medical service. (a fixed dollar amount) and/or coinsurances (a percentage amount) that you must pay when you pick up your prescriptions. The following table shows you those costs.
| Tier | Preferred | Standard |
|---|---|---|
| 1 (Preferred Generic) | $0.00 copay (deductible does not apply) | $8.00 copay (deductible does not apply) |
| 2 (Generic) | $5.00 copay | $15.00 copay |
| 3 (Preferred Brand) | $44.00 copay | $47.00 copay |
| 4 (Non-Preferred Drug) | 47% | 50% |
| 5 (Specialty Tier) | 25% | 25% |
| 6 (Select Diabetic Drugs) | $11.00 copay | $11.00 copay |
A Brief Review and CMS 5-Star Rating Marks
This Medicare Part D plan gets 3.0 out of 5 stars overall. Here's our quick summary of how well Wellcare Value Script performs.
In terms of quality, safety, and customer service, this Massachusetts Part D plan is just average. Wellcare Value Script does an average job helping member when they call with an issue. When it comes to member complaints to Medicare, this plan does an average job. Medicare beneficiaries enrolled in this WellCare plan enjoy a good member experience. Drug safety and the accuracy of drug pricing with this plan are about average.
You can't judge a Part D plan on its monthly premium or annual deductible. You have to look at the overall cost of your prescriptions. Most enhanced benefit plans have a higher premium than this one, but does it offer enhanced value on the medications you need? This plan has a deductible, but one tier is excluded (see table above).
Each year the Centers for Medicare & Medicaid ServicesThe Centers for Medicare & Medicaid Services (CMS) is the U.S. Federal agency that runs the Medicare, Medicaid, and Children’s Health Insurance Programs. (CMS) rates drug plans (Part D) in four broad categories. We do not recommend joining a plan with an overall rating of less than 3.0. Here are the most recent CMS ratings for this plan:
| CMS Measure | Star Rating |
|---|---|
| Overall Plan Rating | |
| Drug Plan Customer Service | |
| Complaints and Changes in the Drug Plan | |
| Member Experience with the Drug Plan | |
| Drug Safety and Accuracy of Drug Pricing |
Additional Enhanced Medicare Part D Plan Options in Massachusetts
Here are some additional plans in your area that might be worth reviewing:
- Clear Spring Health Premier Rx
- Humana Walmart Value Rx Plan
- Mutual of Omaha Rx Premier
- Blue MedicareRx Premier
- AARP MedicareRx Preferred
Contact WellCare
| Plan Website: | WellCare Plan Information |
|---|---|
| Formulay Information: | WellCare Formulary Information |
| Pharmacy Information: | WellCare Pharmacy Information |
| Prospective Members: | (888)900-4307 |
| TTY Users: | (888)816-5252 |
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 AdvantageMedicare Advantage (MA), also known as Medicare Part C, are health plans from private insurance companies that are available to people eligible for Original Medicare (Medicare Part A and Medicare Part B). program on www.medicare.gov.
Citations & References
- WellCare, "http://www.wellcare.com/PDP", Last Accessed October 15, 2021
- Medicare.gov, "How to get prescription drug coverage", Last Accessed August 28, 2022
- Medicare.gov, "How Part D works with other insurance", Last Accessed August 14, 2022
- Medicare.gov, "Catastrophic coverage", Last Accessed June 13, 2022
- SSA.gov, "Extra Help with Medicare Prescription Drug Plan Costs", Last Accessed June 9, 2022
- CMS.gov, "Landscape Source Files", Last Accessed January 15, 2023
- CMS.gov, "Medicare Part C & D Performance", Last Accessed January 15, 2023
The 2023 Medicare Part D Plans for Massachusetts information on this page was last updated on .