AARP MedicareRx Preferred is a prescription drug plan available in Connecticut. This 2018 Medicare Part D plan is approved by the Centers for Medicare and Medicaid Services (CMS) for people with Medicare benefits.
Be sure to have a look at the five most important components of the AARP MedicareRx Preferred plan before finalizing your enrollment decision:
- Premium & Deductible: The premium is the amount you pay to be in the plan. This is the monthly cost of membership. In addition, plans may have an annual deductible. This is an amount that you pay towards your prescription costs before cost sharing begins.
- Co-pays & Co-insurance: This is where many people pay more than they should. Prescription co-payments (what you pay at the pharmacy) vary widely based on the formulary tier your drug is in. It's critical to verify that your medications are covered at the lowest tier possible.
- Coverage Phases: All Medicare Part D plans have an initial coverage phase, followed by a coverage gap phase, followed by a catastrophic coverage phase. The phase you're in will largely depend on the cost of your prescriptions. Some plans offer additional coverage in the gap phase. If you have costly medications, look for a plan with additional gap coverage.
- Medication Cost: One of the most challenging aspects of the Medicare Part D program is finding your prescription at the best price. It has as much to do with the pharmacy you use as it does the plan itself. This is because plans have preferred pharmacies and pharmacies have different contracts with pharmaceutical manufactures. Here's a secret, use our friends at GoodRx.com to find your prescription at the best price in your town.
- 5-Star Ratings: Critical measurements, by Medicare, will help you see how well this plan will care for you.
Detailed Cost Information
The AARP MedicareRx Preferred plan does not cover all of your prescription costs. The costs are shared. Your costs includes the monthly premium, an annual deductible (if applicable), and co-payments and/or co-insurance when you pickup your prescriptions.
The annual premium is $936.00 ($78.00 paid monthly). It breaks down as follows:
You can't join the AARP MedicareRx Preferred plan if you have low income subsidy (LIS) benefits.
This plan has a $0.00 deductible (annual).
A zero dollar ($0.00) deductible, like this plan has, gives you first dollar coverage. Some PDPs have a deductible (up to $400 per year in 2018) that you must pay out-of-pocket before coverage begins.
Your Out-of-Pocket Costs: Premium + Deductible + Co-pay
Here's a rundown of your shared costs. 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)
Your Costs May Be Different
There are two situations that change change what you pay. If you're accepted into the Extra Help program, administered by the Social Security Administration, your premium could be lower. It's also possible that your premium could be higher if you have a late entry penalty because you did not enroll when first eligible.
Details of Plan Coverage
AARP MedicareRx Preferred is a Enhanced Alternative plan. By law, UnitedHealthcare is required to offer a standard benefit package. The standard benefit has an annual deductible, an initial coverage limit, a gap in coverage (donut hole), and a catastrophic coverage phase. Insurance carriers have the option to offer plans that:
- are an actuarial equivalent to the standard benefit; or
- provide enhanced benefits, as compared to the standard benefit.
Most enhanced plans provide additional coverage in the coverage gap phase. If your medications are costly, shop and compare enhanced plans.
Initial Coverage Limit Phase
The ICL is the same for all Connecticut 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 $3750.00 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 Connecticut.
Coverage Gap Phase
If you reach the coverage gap phase, or donut hole, as many people call it, you are essentially uninsured and must pay for all of your prescription costs out-of-pocket. When you reach the coverage gap with the AARP MedicareRx Preferred plan will all depend on your prescriptions. Most people never exceed the ICL and don't have to worry about it. If you are on a long-term medication that's costly, you could reach the donut hole very quickly.
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.
Enhanced Gap Coverage
AARP MedicareRx Preferred has limited coverage in the gap coverage phase. Call or review the plan's Summary of Benefits for additional information. If you went into the coverage gap phase last year, and could not afford your medications, call with your local Connecticut Medicaid office and the Social Security Administration (SSA). The SSA's Extra Help program helps people who can't pay for their prescriptions.
Catastrophic Coverage Phase
The final phase is catastrophic coverage. You reach this phase once you've spent $4,950 out-of-pocket. With catastrophic coverage you pay a small co-insurance or co-payment on your covered medication for the remainder of the year.
Co-payment & Co-insurance Details
In addition to the monthly premium and annual deductible, the AARP MedicareRx Preferred prescription drug plan has co-payments (fixed dollar amount) and/or co-insurances (percentage) that you must pay when you pickup your medications. Here's the schedule for this plan:
|Tier||You Pay||Tier Description|
CRITICAL: To understand how much you will pay at the pharmacy if you join this plan, you must find the tier of each of your prescriptions in the plan's formulary.
TIP: Use the GoodRx Medicare tools to find your prescription at the best price in your town.
CMS 5-Star Ratings
The annual CMS plan ratings are important. Each year CMS rates PDPs across four categories. Ratings offer a good clue as to the quality of service you can expect if you join the 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|
UnitedHealthcare Contact Information
Here's the new member contact information for UnitedHealthcare:
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 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 Hartford, Bridgeport, Stamford, Norwalk, New Haven, Milford, Danbury, Bristol, Meriden, West Haven, and all other towns and cities in Connecticut.
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