Cigna Secure-Essential Rx Oklahoma Medicare Part D Plan

Cigna Secure-Essential Rx is a 3.5 Star Medicare Prescription Drug Plan Available in Oklahoma

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 Average, and rated it 3.5 out of 5.0 stars.

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

Cigna Secure-Essential Rx does not pay all costs; it's a cost-sharing plan. If you join, you share in the overall costs with Cigna-HealthSpring Rx 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 $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

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 pick up 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 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 Oklahoma Medicare Insurance Agent.

Coverage Details

Cigna Secure-Essential Rx is a Enhanced PDP. At a minimum, Cigna-HealthSpring Rx 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

Confused about the initial coverage limit? Don't be, because it's straight forward. If you enroll in the Cigna Secure-Essential Rx PDP, you share the cost of your prescriptions with Cigna-HealthSpring Rx. You each pay your share until the amount spent at the pharmacy reaches $4130.00 (retail spending amount). That's the initial coverage limit in Oklahoma for plan year 2021. After that, you are not covered (coverage gap) until your actual 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.... qualify you for catastrophic coverage. Keep reading, because you are entitled to automatic discounts.

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 Cigna Secure-Essential Rx all depends on your prescriptions. Most seniors never fall into the donut hole.

In the coverage gap phase you are responsible for the full cost of your prescription drugs up until your total out-of-pocket expenses reach $6,350 (excluding 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 expense paid by insurance) minus a 75% discount on both brand-name prescription drugs and generics. Once you reach $6,350 in out-of-pocket expenses, you're out of the coverage gap. At this point, you automatically get catastrophic coverage through Medicare, which assures you only pay a small amount for covered drugs for the remainder of the year.

Additional Gap Coverage

Cigna Secure-Essential Rx 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 Oklahoma 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 Cigna Secure-Essential Rx 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 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 Cigna-HealthSpring Rx plan.

Contact Cigna-HealthSpring Rx

Here's the new member contact information for Cigna-HealthSpring Rx:

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 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.... (Part A and Part B), and all Oklahoma Medicare supplement plans. It is also compatible with Medicare Advantage plans in Oklahoma, 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 Cigna Secure-Essential Rx prescription drug plan. Unless you also receive benefits from Medicaid, enrollment in a Part D plan is voluntary. This plan is available in Oklahoma City, Tulsa, Norman, Lawton, Broken Arrow, Edmond, Enid, Stillwater, Muskogee, and all other towns and cities in Oklahoma.

The Medicare Part D information on this page originates from CMS Landscape Source Files, is maintained by David Bynon, and was last updated on September 21, 2021 .