WellCare Value Script Missouri Medicare Part D Plan

WellCare Value Script is a 4.0 Star Medicare Part D Plan for Medicare Beneficiaries in Missouri

The Centers for Medicare & Medicaid Services (CMS) evaluated this Medicare Part D plan's previous year performance and rated it 4.0 out of 5 stars (Above Average) for quality.

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. Plus, 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.

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

This plan is not available to people receiving full Low Income Subsidy (LIS) benefits.

Deductible

This plan has a $445.00 deductible (annual).

For 2021, the maximum Part D deductible is $435. 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

Most people pay the standard premium. However, if you qualify for Extra Help with your Medicare Part DMedicare Part D is Medicare's prescription drug plan program. Plans are offered by private insurance companies and cover outpatient prescriptions.... 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 Missouri Medicare Insurance Agent.

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.

Initial Coverage Limit

It's important to understand the initial coverage limit (ICL) and how it applies to you in Missouri. 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 $4130.00 (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.

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 people don't), then you are responsible for 100% of your prescription costs until your out-of-pocket costsOut-of-pocket costs (aka, out-of-pocket medical expenses) are costs that a beneficiary must pay because their health insurance does not cover them. Out-of-pocket costs are found in the deductibles, copayments, and coinsurance outlined in each health... hit $6,350 (excluding 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. ... and the amount paid by the plan). This is called the coverage gap or donut hole. The good news is that you get a 75% discount on your brand-name prescription drugs and your generic medications while you're in the gap. You get to the other side of the donut hole when you've spent $6,350, 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 Missouri 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 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 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 D program on www.medicare.gov. For information about the SSA's Extra Help program, download the Understanding Extra Help guide.

Compatibility

This stand-alone Medicare prescription drug plan is compatible with traditional Medicare (Part A and Part B), and all Missouri Medicare supplement plans. It is also compatible with Medicare Advantage plans in Missouri, so long as the plan does not include Part D.

Availability

If you are entitled to Medicare Part AMedicare Part A is hospital inpatient coverage for people with Original Medicare, whereas Part B is medical coverage for doctor visits, tests, etc.... (enrolled or not) or currently enrolled in Medicare Part BMedicare Part B is medical coverage for people with Original Medicare. It covers doctor visits, specialists, lab tests and diagnostics, and durable medical equipment. Part A is for hospital inpatient care.... 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 Saint Louis, Kansas City, Springfield, Independence, Columbia, Lees Summit, O'Fallon, Saint Joseph, Saint Charles, Blue Springs, Saint Peters, Florissant, Joplin, Chesterfield, and all other towns and cities in Missouri.

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 19, 2021 .