AARP MedicareRx Preferred West Virginia Medicare Part D Plan

AARP MedicareRx Preferred is a 3.5 Star Medicare Part D Plan for Medicare Beneficiaries in West Virginia

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 sharing 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

AARP MedicareRx Preferred does not pay all costs; it's a cost-sharing plan. If you join, you share in the overall costs with UnitedHealthcare 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 $0.00 deductible (annual).

A zero dollar ($0.00) deductible means you have first dollar coverage. Many Part D Plans have a deductible (up to $480 per year in 2022) that must be paid before your prescription coverage assistance kicks in.

Your Costs Include the Monthly Premium + Deductible + Copayments

Here's a rundown of your shared costsAn 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.. 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)

Potential Additional Costs

There are two conditions that could affect how much you pay for this plan. If you qualify for the Social Security Extra Help program your premium will generally be lower. Also, if you enrolled late the Centers for Medicare and MedicaidMedicaid is a public health insurance program that provides health care coverage to low-income families and individuals in the United States. Service may impose a premium penalty. Contact your local West Virginia Medicare Insurance Agent to get an exact quote for your situation.

Coverage Details

AARP MedicareRx Preferred is a Enhanced PDP. At a minimum, UnitedHealthcare 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.

The Initial Coverage Limit

The Initial Coverage Limit is the same for all West Virginia plans, but it changes from year to year. If you enroll in AARP MedicareRx Preferred you share the cost of all covered medications with UnitedHealthcare. You each pay your share until $4430.00 (retail spending) has been spent at the pharmacy. If you reach that level of spending on your prescriptions then you fall into the dreaded coverage gap and you are responsible for all costs. Fortunately, automatic discounts kick in to help you until you qualify for Medicare's catastrophic coverage in West Virginia.

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.

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 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. hit $7,050 (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 $7,050, at which point you automatically qualify to receive catastrophic coverage from Medicare.

Additional Gap Coverage

AARP MedicareRx Preferred 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 West Virginia 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 AARP MedicareRx Preferred 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 UnitedHealthcare plan.

Contact UnitedHealthcare

Here's the new member contact information for UnitedHealthcare:

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

This stand-alone Medicare Part D plan is compatible with 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. (hospital insurance) and 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. (medical insurance), and all West Virginia Medigap plans. It's also compatible with Medicare Part C plans in West Virginia, so long as the plan does not include prescription drug coverage.

Availability

If you are entitled to Medicare Part A (enrolled or not) or currently enrolled in Medicare Part B you may join the AARP MedicareRx Preferred prescription drug plan. Unless you also receive benefits from Medicaid, enrollment in a Part D plan is voluntary. This plan is available in Charleston, Huntington, Parkersburg, Morgantown, Wheeling, and all other towns and cities in West Virginia.

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 4, 2022 .