AARP MedicareRx Saver Plus is a prescription drug plan available in Ohio. This 2018 Medicare Part D plan is approved by the Centers for Medicare and Medicaid Services (CMS) for people with Medicare benefits.
We suggest looking at the five most important parts of the AARP MedicareRx Saver Plus plan before enrolling:
- 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
This is a cost sharing plan, which includes a premium (monthly), a deductible (annual), and pharmacy co-pays and/or co-insurance.
The premium is $49.40 per month ($592.80 annual cost). Here's how it breaks down:
You can't join the AARP MedicareRx Saver Plus plan if you have low income subsidy (LIS) benefits.
The annual deductible is $405.00.
The Part D deductible is capped at $405 (2018 level). A plan with the maximum deductible is not always more expensive than a similar plan with a lower deductible. You must factor in all costs (premium, deductible, co-pay and pharmacy price).
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
Most people pay the standard premium. However, if you get Extra Help from Social Security, due to your income, your premium will be less. That's one situation. The other is a penalty for not enrolling on-time. In this case, Medicare can impose a penalty and your premium will be higher.
Details of Plan Coverage
AARP MedicareRx Saver Plus is a Actuarially Equivalent Standard 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
Confused about the initial coverage limit? Don't be, because it's straight forward. If you enroll in the AARP MedicareRx Saver Plus PDP, you share the cost of your prescriptions with UnitedHealthcare. You each pay your share until the amount spent at the pharmacy reaches $3750.00. That's the initial coverage limit in Ohio for plan year 2018. After that you are not covered (coverage gap) until your actual out-of-pocket costs qualify you for catastrophic coverage. Keep reading, because you are entitled to automatic discounts.
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 Saver Plus 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.
In the coverage gap phase you are responsible for the full cost of your prescription drugs up until your total out-of-pocket expenses reach $4,550 (excluding premiums and expense paid by insurance) minus a 47.5% discount on brand-name prescription drugs and a 28% discount on generic drugs. Once you reach $4,550 in out-of-pocket expenses, you're out of the coverage gap. At this point you automatically get catastrophic coverage through Medicare, which assures you only pay a small amount for covered drugs for the remainder of the year.
Enhanced Gap Coverage
AARP MedicareRx Saver Plus does not offer coverage gap assistance. If went into the coverage gap phase last year, and you were unable to afford your prescriptions, call your local Ohio Medicaid office about assistance. The Extra Help program, from the Social Security Administration, may also be available to help you afford your medications.
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 Saver Plus 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 Saver Plus prescription drug plan. Unless you also receive benefits from Medicaid, enrollment in a Part D plan is voluntary. This plan is available in Cincinnati, Cleveland, Elyria, Columbus, Dayton, Akron, Toledo, Youngstown, Euclid, Parma, Canton, Lorain, Hamilton, Springfield, Kettering, Lakewood, Cuyahoga Falls, Middletown, and all other towns and cities in Ohio.
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