EnvisionRxPlus for Hawaii is Medicare Prescription Drug Plan (Part D Plan or PDP) for seniors and other Medicare beneficiaries in Hawaii.
The Centers for Medicare & Medicaid Services (CMS) evaluated this Medicare Part D plan's previous year performance and rated it 3.0 out of 5 stars (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. Plud, 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.
EnvisionRxPlus is a cost sharing prescription drug plan (PDP). There are three distinct costs: monthly premiums, an annual deductible, and co-payments or co-insurance.
The annual premium on this PDP is $553.20 ($46.10 per month), and breaks down as follows:
This plan is not available to people receiving low income subsidy (LIS) benefits.
There is a $405.00 annual deductible with this PDP.
For 2018, the maximum Part D deductible in 2017 is $400. 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
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 Medicaid Service may impose a premium penalty. Contact your local Hawaii Medicare Insurance Agent to get an exact quote for your situation.
EnvisionRxPlus is a Actuarially Equivalent Standard PDP. At a minimum, EnvisionRx Plus 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 Hawaii. The ICL is where you share the cost of your prescriptions with the insurance company. You and EnvisionRx Plus each pay your share until you reach a total of $3750.00 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 seniors don't), then you are responsible for 100% of your prescription costs until your out-of-pocket costs hit $4,550 (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 47.5% discount on brand-name prescription drugs and a 28% discount on generic drugs while you're in the gap. You get to the other side of the donut hole when you've spent $4,550, at which point you automatically qualify to receive catastrophic coverage from Medicare.
Additional Gap Coverage
EnvisionRxPlus 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 Hawaii 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 EnvisionRxPlus 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:
|Tier||You Pay||Tier Description|
IMPORTANT: In order to determine if this is the best PDP for you, it's critical that you lookup 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 EnvisionRx Plus plan.
|2018 Overall Rating|
|Drug Plan Customer Service|
|Complaints and Changes in the Drug Plan|
|Member Experience with the Drug Plan|
|Drug Safety and Accuracy of Drug Pricing|
Contact EnvisionRx Plus
Here's the new member contact information for EnvisionRx Plus:
For assistance 24 hours a day, call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048 or visit www.medicare.gov
If you are entitled to Medicare Part A (enrolled or not) or currently enrolled in Medicare Part B you may join the EnvisionRxPlus prescription drug plan. Unless you also receive benefits from Medicaid, enrollment in a Part D plan is voluntary. This plan is available in Honolulu, and all other towns and cities in Hawaii.
Tips and Disclaimers
The MedicareWire.com website is available for educational purposes. Our goal is to present information accurately and without bias, based on our interpretation of factual information. However, this site is not intended as a substitute for legal, health, or financial advice from a licensed professional. On this page we help consumers:
Compare EnvisionRxPlus, a Medicare Part D Plan available in Hawaii for $46.10/month with a $405.00 annual deductible, with all 2018 Medicare Prescription Drug Plans in HI. Find the best PDP plan for the medications you take and start saving.
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This Medicare plan information is maintained by David Bynon and was last updated on .
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