WellCare Value Script Nevada Medicare Part D Plan

WellCare Value Script is a 4.0 Star Medicare Prescription Drug Plan Available in Nevada

According to 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), this prescription drug plan's quality is Above Average, and rated it 4.0 out of 5.0 stars.

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

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. This plan's annual premium is $219.60 ($18.30 paid monthly). It's priced as follows:

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

Here's a rundown of your shared costs. Like all other types of insurance, you must pay your premium. The premium has nothing to do with how many prescriptions you have filled. If the plan has a deductible, you must pay one hundred percent of your prescription costs until you reach the amount of the deductible. When the deductible is met, then you pay the copayment amount at the pharmacy. All other costs are paid by the plan until you hit the donut hole (initial coverage limit)

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 Nevada 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 Nevada. 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.

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 (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... reach $6,350. At this point, Medicare takes over by giving you catastrophic coverage. The $4,550 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 Nevada 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 copaymentsA copayment, also known as a copay, is a set dollar amount you are required to pay for a medical service.... (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 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.

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

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 Nevada. It can also be used with Nevada 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 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 Las Vegas, Henderson, Paradise, Reno, Sparks, Carson City, and all other towns and cities in Nevada.

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 20, 2021 .