WellCare Medicare Rx Saver is a 3.5 Star Medicare Part D Plan for Medicare Beneficiaries in Arizona
According to the Centers for Medicare and Medicaid Services (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 & 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.
This is a cost-sharing based prescription drug plan (PDP). With the WellCare Medicare Rx Saver 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 $380.40 ($31.70 paid monthly). It's priced as follows:
This plan qualifies for the full, low income subsidy benefit. The following table details subsidised premium amounts:
|Subsidy Level||Monthly Premium|
This plan has a $435.00 deductible (annual).
For 2020, 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 D 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 Arizona Medicare Insurance Agent.
WellCare Medicare Rx Saver is a Basic PDP. At a minimum, Aetna Medicare 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 Arizona. The ICL is where you share the cost of your prescriptions with the insurance company. You and Aetna Medicare each pay your share until you reach a total of $4020.00 (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)
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.
If you reach the ICL (most people don't), then you are responsible for 100% of your prescription costs until your out-of-pocket costs hit $6,350 (excluding your monthly 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 Medicare Rx Saver 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 Arizona Medicaid 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 Medicare Rx Saver 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 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 Aetna Medicare plan.
Contact Aetna Medicare
Here's the new member contact information for Aetna Medicare:
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.
This stand-alone Medicare Part D plan is compatible with Medicare Part A (hospital insurance) and Medicare Part B (medical insurance), and all Arizona Medigap plans. It's also compatible with Medicare Part C plans in Arizona, so long as the plan does not include prescription drug coverage.
If you are entitled to Medicare Part A (enrolled or not) or currently enrolled in Medicare Part B you may join the WellCare Medicare Rx Saver prescription drug plan. Unless you also receive benefits from Medicaid, enrollment in a Part D plan is voluntary. This plan is available in Scottsdale, Phoenix, Peoria, Surprise, Mesa, Tucson, Tempe, Yuma, Avondale, Buckeye, Chandler, Goodyear, Gilbert, Lake Havasu City, Flagstaff, Bullhead City, and all other towns and cities in Arizona.