Wellcare Value Script Tennessee Medicare Part D Plan

Wellcare Value Script is a 3.5 Star Medicare Prescription Drug Plan Available in Tennessee

CMS gave this prescription drug plan a quality rating of 3.5 out of 5.0 stars (Average).

These are the areas of the plan that are important to compare and review:

• Premium & DeductibleA deductible is an amount a beneficiary must pay for their health care expenses before the health insurance policy begins to pay its share.: The premium is the amount you will pay monthly. Plus, many plans have an annual deductible that must be met before cost sharingAn amount patients pay for their share of the cost of medical service or supply, like a doctor’s visit, hospital inpatient visit, or prescription drug. begins.
• Coverage Phases: Part D plans have 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..., followed by a coverage gapA period of time in which you pay higher cost-sharing for prescription drugs until you spend enough to qualify for catastrophic coverage., 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.

Cost Details

Wellcare Value Script does not pay all costs; it's a cost-sharing plan. If you join, you share in the overall costs with WellCare by paying a monthly premium, an annual deductible (if applicable), and copaymentsA copayment, also known as a copay, is a set dollar amount you are required to pay for a medical service. and/or coinsuranceCoinsurance is a percentage of the total you are required to pay for a medical service.  at your pharmacy.

Low-Income Subsidy ("Extra Help")

This plan does not qualify for Extra Help (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...) benefits.

Deductible

This plan has a $480.00 deductible (annual).

For 2022, the maximum Part D deductible is $480. 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

You are required to pay your premium each month, even if you don't fill a prescription. Plus, you'll pay all of your prescription costs until the annual deductible amount has been paid (if any). You'll also pay the required copayment at your pharmacy when you have your prescriptions filled. These are your costs and the plan pays the rest.

What You Pay Could Be Different

There are two situations that can change your monthly premium. 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 Tennessee Medicare Insurance Agent to get an exact quote for your situation.

Coverage Details

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.

Most Cost Sharing is in the Initial Coverage Limit Phase

It's important to understand the initial coverage limit (ICL) and how it applies to you in Tennessee. The ICL is where you share the cost of your prescriptions with the insurance company. You and WellCare each pay your share until you reach a total of $4430.00 (retail spending) spent at the pharmacy on prescriptions. At that point, you pay all costs yourself because you're in the coverage gap, as explained below.

The Coverage Gap Phase

When you reach the coverage gap, commonly called the donut hole, you pay for your medications yourself. Most seniors never go into the coverage gap, but it is possible to hit it quickly if you have expensive long-term prescriptions.

When you're in the donut hole you pay all of the costs for your medications, but at a discounted rate (75% off of both brand-name drugs and generics). You continue to pay this until your out-of-pocket costsOut-of-Pocket Costs for Medicare are the remaining costs that are not covered by the beneficiary's health insurance plan. These costs can come from the beneficiary's monthly premiums, deductibles, coinsurance, and copayments. reach $7,050. At this point, Medicare takes over by giving you catastrophic coverage. The $7,050 out-of-pocket figure does not include your monthly premiumsA 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.  or what WellCare pays.

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 Tennessee MedicaidMedicaid is a public health insurance program that provides health care coverage to low-income families and individuals in the United States. 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:

IMPORTANT: In order to determine if this is the best PDP for you, it's critical that you look up your prescriptions in the plan's formularyA formulary is a list of prescription drugs covered by a prescription drug plan or another insurance plan offering prescription drug benefits. Medications not on a plan's formulary are generally not covered..

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 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 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.

Contact WellCare

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 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... program on www.medicare.gov. For information about the SSA's Extra Help program, download the Understanding Extra Help guide.

Compatibility

Wellcare Value Script can be used in conjunction with Original MedicareOriginal Medicare is private fee-for-service health insurance for people on Medicare. It has two parts. Part A is hospital coverage. Part B is medical coverage. (Parts A and B), and all Medicare supplement plans in Tennessee. It can also be used with Tennessee Medicare Advantage plans, but only if the Part C plan does not include Part D.

Availability

If you are entitled to Medicare Part AMedicare Part A is hospital coverage for Medicare beneficiaries. It covers inpatient care in hospitals and skilled nursing facilities. It also covers limited home healthcare services and hospice care. (enrolled or not) or currently enrolled in Medicare Part BMedicare Part B is medical coverage for people with Original Medicare benefits. It covers doctor visits, preventative care, tests, durable medical equipment, and supplies. Medicare Part B pays 80 percent of most medically necessary healthcare services. 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 Nashville, Murfreesboro, Memphis, Knoxville, Chattanooga, Clarksville, Jackson, Johnson City, Franklin, Hendersonville, Kingsport, and all other towns and cities in Tennessee.

The Medicare Part D information on this page originates from CMS Landscape Source Files, is maintained by David Bynon, and was last updated on May 2, 2022 .