Wellcare Medicare Rx Value Plus (Enhanced PDP) A 2023 Medicare Part D Plan Review
Wellcare Medicare Rx Value Plus is a 2023 Enhanced 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... plan (S4802-223) from WellCare that's available to people with Medicare Part A and/or Part B or a Medicare Advantage plan that does not include prescription benefits.
This is a cost-sharing plan that has 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... of $4,660 and a $0.00 annual deductibleA deductible is an amount a beneficiary must pay for their health care expenses before the health insurance policy begins to pay its share.. CMS rated this plan 3.0 (Average) out of 5 stars.
Key Takeaways
- Wellcare Medicare Rx Value Plus is an enhanced benefit Medicare Part D plan.
- Enhanced benefit plans have a higher actuarial value than basic benefit plans.
- Actuarial value simply refers to the percentage of cost covered by the plan.
- The monthly premiumA 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. is $71.30
- The annual deductible is $0.00.
- This WellCare plan does not offer additional coverage in the coverage gap (aka, "donut hole").
- This plan does not qualify for the Extra Help program's full 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 and prescription costs vary widely from plan to plan, so if you have regular prescriptions it's important to carefully compare what your costs will be.
| Plan Basics | |
|---|---|
| Plan ID: | S4802-223 |
| Plan Type: | PDP |
| Plan Year: | 2023 |
| Premium: | $71.30/mo |
| Deductible: | $0.00/yr |
| Benefit Type: | Enhanced |
| Rx Gap Coverage: | No |
| Low Income Subsidy: | No |
| Availability: | See List |
| Insured By: | WellCare |
WARNING: Before enrolling in a Part D plan, take the time to evaluate the cost of your regular prescriptions.
Prescription Drug Plan Premium
Although Wellcare Medicare Rx Value Plus's monthly premium is bundled with the total plan cost, some plans have supplemental costs and/or offer low-income subsidy (LIS) assistance. The following table outlines the premium details of this WellCare plan.
| Basic Part D Premium: | $30.50 |
| Supplemental Part D Premium: | $40.80 |
| Total Part D Premium: | $71.30 |
| Part D Premium with Full LIS Assistance: | $40.80 |
| Part D Premium with 75% LIS Assistance: | $48.40 |
| Part D Premium with 50% LIS Assistance: | $56.00 |
| Part D Premium with 25% LIS Assistance: | $63.70 |
For more information about the Low-Income Subsidy (aka, "Extra Help") program, refer to the Social Security Extra Help page.
Prescription Drug Plan Deductible
The Medicare Part D annual deductible with this plan is $0.00. This is the amount you must pay at the pharmacy before WellCare begins paying its share.
Prescription Drug Plan Out-of-Pocket Costs
In addition to the plan's monthly premium and deductible, Wellcare Medicare Rx Value Plus has copaymentsA copayment, also known as a copay, is a set dollar amount you are required to pay for a medical service. (a fixed dollar amount) and/or coinsurances (a percentage amount) that you must pay when you pick up your prescriptions. The following table shows you those costs.
| Tier | Preferred | Standard |
|---|---|---|
| 1 (Preferred Generic) | $0.00 copay | $10.00 copay |
| 2 (Generic) | $4.00 copay | $20.00 copay |
| 3 (Preferred Brand) | $47.00 copay | $47.00 copay |
| 4 (Non-Preferred Drug) | 50% | 50% |
| 5 (Specialty Tier) | 33% | 33% |
| 6 (Select Diabetic Drugs) | $11.00 copay | $11.00 copay |
A Brief Review and CMS 5-Star Rating Marks
This Medicare Part D plan gets 3.0 out of 5 stars overall. Here's our quick summary of how well Wellcare Medicare Rx Value Plus performs.
Most Part D plans get average marks, including this one. Wellcare Medicare Rx Value Plus does an average job helping member when they call with an issue. When it comes to member complaints to Medicare, this plan does an average job. Medicare beneficiaries enrolled in this WellCare plan enjoy a good member experience. Drug safety and the accuracy of drug pricing with this plan are about average.
You can't judge a Part D plan on its monthly premium or annual deductible. You have to look at the overall cost of your prescriptions. You can find enhanced benefit plans that have a lower monthly cost than this one. If the plan covers your prescriptions at a lower price overall, that's fine. This plan comes with a zero-dollar deductible, so you have first-dollar coverage.
The following table shows the quality ratings for this WellCare plan. Each year CMS rates drug plans (Part D) in four broad categories. We do not recommend joining a plan with an overall rating of less than 3.0:
| CMS Measure | Star Rating |
|---|---|
| Overall Plan 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 |
Plan Availability
Wellcare Medicare Rx Value Plus is available in the following states:
Contact WellCare
| Plan Website: | WellCare Plan Information |
|---|---|
| Formulay Information: | WellCare Formulary Information |
| Pharmacy Information: | WellCare Pharmacy Information |
| Prospective Members: | (888)900-4307 |
| TTY Users: | (888)816-5252 |
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 AdvantageMedicare Advantage (MA), also known as Medicare Part C, are health plans from private insurance companies that are available to people eligible for Original Medicare (Medicare Part A and Medicare Part B). program on www.medicare.gov.
Citations & References
- WellCare, "http://www.wellcare.com/PDP", Last Accessed October 15, 2021
- Medicare.gov, "Your Guide to Medicare", Last Accessed September 3, 2022
- Benefits.gov, "Medicare Prescription Drug Plans", Last Accessed October 1, 2022
- Medicare.gov, "Catastrophic coverage", Last Accessed June 13, 2022
- SSA.gov, "Understanding the Extra Help With Your Medicare", Last Accessed June 9, 2022
- CMS.gov, "Landscape Source Files", Last Accessed January 15, 2023
- CMS.gov, "Medicare Part C & D Performance", Last Accessed January 15, 2023
The 2023 Medicare Part D Plans for information on this page was last updated on .