2010 PrescribaRxSM PDP Plans
PrescribaRx plans are offered in the 48 continental United States and the District of Columbia.
What plan is right for you?
Compare your plan options. Use the chart below for an overview of PrescribaRx PDP benefits and copays.
| PrescribaRx Bronze Plan (PDP) |
PrescribaRx Gold Plan (PDP) |
|
| Monthly Premium* | As low as $17.90 (depending on service area) | As low as $29.80 (depending on service area) |
| 2010 MEDICARE PART D PRESCRIPTION DRUG COVERAGE | ||
| Phase 1: DEDUCTIBLE |
$310 | $150 |
| Phase 2: INITIAL COVERAGE |
Amount paid for covered prescriptions by you and your plan (not including plan premiums) until the $2,830 limit is reached | |
| You pay: | 30-day / 90-day supply | |
| Generic Drugs | 25% coinsurance | $6 / $12 |
| Brands Drugs | 25% coinsurance | $43 / $86 |
| Specialty Drugs | 25% coinsurance | 29% coinsurance |
| Phase 3: GAP COVERAGE |
Amount you pay for prescription between the Initial coverage and until you reach $4,550 in out-of-pocket covered prescription drug costs | |
| You pay: | 30-day / 90-day supply | |
| Generic Drugs | 100% of the cost | 100% of the cost |
| Brands Drugs | 100% of the cost | 100% of the cost |
| Specialty Drugs | 100% of the cost | 100% of the cost |
| Phase 4: CATASTROPHIC COVERAGE |
Amount you pay for prescriptions after you reach $4,550 in out of pocket covered prescription drug costs | |
| You pay: | 30-day supply | |
| Generic Drugs | The greater of $2.50 or 5% coinsurance | |
| Brand Drugs | The greater of $6.30 or 5% coinsurance | |
*You must continue to pay your Medicare Part B premium
If you decide to switch to premium withhold or move from premium withhold to direct bill, it could take up to three months for it to take effect and you will remain responsible for those premiums.
You may be able to get Extra Help to pay for your prescription drug premiums and costs. To see if you qualify for getting Extra Help, call:
- 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/7days a week);
- The Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or
- Your State Medicaid Office.
Note: PrescribaRx has formed a network of pharmacies. You must use a network pharmacy to receive plan benefits. We will not pay for your prescriptions if you use an out-of-network pharmacy, except in certain cases. The pharmacies in our network can change at any time.You can ask for a Pharmacy Directory or visit our website.
For full information on plan benefits, call our Customer Service Department at 1-866-249-8668 8:00 a.m. to 8:00 p.m. in your local time zone (TTY users call: 1-800-777-9083) every day.
