Coverage beyond Original Medicare.
Wellcare Medicare Prescription Drug Plans help to cover the cost of prescription drugs. Our plans offer coverage and support for the medications you need to help you feel your best and stay independent. This is in addition to other plans.
Topics
- What is a Medicare Prescription Drug Plan?
- Who is eligible?
- Our Part D Plan Benefits
- Our Part D Plans
- What does a Part D plan cost?
- Medicare Part D Glossary of Terms
What is a Medicare Prescription Drug Plan?
A Prescription Drug Plan (PDP) is a Medicare Part D plan that helps pay for prescription medications. It is offered by private insurance companies, like Wellcare, that are approved by Medicare and is designed to work alongside Original Medicare (Part A and/or Part B).
Who is Eligible for a Medicare Part D plan?
Most people become eligible for Medicare when they turn 65. Some may qualify earlier due to a disability or certain medical conditions. You can join a prescription drug plan if you have Medicare Part A, Part B, or both, and live in the plan’s service area
Our Part D Plan Benefit
Our Prescription Drug Plans offer benefits that can help make your prescriptions more affordable and convenient.
- $0 copay for most Part D covered vaccines.
- Convenient medication home delivery through Express Scripts® Pharmacy:
- Get a 90-day supply of your medications delivered to your door.
- Save time with fewer pharmacy trips & easy prescription management.
- $0 copay for a 90-day supply of Tier 1 medications*
- A network of more than 60,000 retail pharmacies including national chains such as CVS*, Walgreens*, regional grocery stores* and independent pharmacies*.
*Classic plan is subject to deductible
Wellcare PDP offers 2 Part D Plans
Wellcare Classic
The Wellcare Classic Plan is designed for those who qualify for Extra Help. If you get Extra Help you may be eligible for $0 premiums and lower copays than those listed in the Summary of Benefits.
Wellcare Value Script
The Wellcare Value Script plan is a low premium plan designed for members seeking affordable prescription drug coverage. It has no deductible on Tier 1 & tier 6 and offers $0 Tier 1 copay at preferred pharmacies.
What does a Part D plan cost?
The cost of a Prescription Drug Plan varies based on the plan you choose, the medications you take, the pharmacy you use, and whether you qualify for Extra Help.
You may pay:
- a monthly premium, the amount you pay for your plan
- an annual deductible, the amount you pay each year before your plan begins to help cover your medication costs
- copays, a fixed dollar amount that you may have to pay for a covered medication when you fill a prescription
- coinsurance, a percentage of the cost of a covered medication
Your costs may also change during the year:
| Deductible stage: | Initial Coverage stage: | Catastrophic Coverage stage: |
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You may pay the full cost until your deductible is met. |
You pay your share of medication costs through copays or coinsurance. |
After you reach the annual out-of-pocket limit, you pay $0 for covered Part D drugs through the rest of the plan year. |
Medicare Part D Glossary of Terms
Here are common terms you may see when comparing Medicare Part D plans.
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Medicare Part D Medicare Part D is prescription drug coverage that helps pay for covered medications. You can get it through a standalone prescription drug plan or through some Medicare Advantage plans. |
Drug Tiers A drug tier is a group of covered drugs that determine how much you may pay. Drugs on lower tiers usually cost less than drugs on higher tiers, though this is not always the case. |
Formulary / Drug List A formulary is a list of prescription drugs covered by your plan. It will also show what drug tier and any coverage rules. Medicare and plan education pages often define formulary as a covered drug list. |
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Prescription Drug Plan / PDP A Prescription Drug Plan, or PDP, is standalone Medicare plan that helps pay for covered prescription drugs and works with Original Medicare. |
Quantity Limits A quantity limit is a coverage rule that limits how much of a drug your plan will cover at one time or during a certain period. |
Deductible A deductible is the amount you may need to pay for covered medications before your plan starts paying its share. Some plans or drug tiers may not have a deductible. |
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Prior Authorization Prior authorization means your plan must approve the drug before it will cover it. |
Premium A premium is the amount you pay each month for your plan coverage. |
Coinsurance Coinsurance is a percentage of a covered drug’s cost that you pay. For example, if your coinsurance is 25%, you pay 25% of the cost of the drug. |
*Other Pharmacies/Physicians/Providers are available in our network.
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Wellcare is the Medicare brand for Centene Corporation, an HMO, PPO, PDP plan with a Medicare contract and is an approved Part D Sponsor. Our D-SNP plans have a contract with the state Medicaid program. Enrollment in our plans depends on contract renewal.“Wellcare” is issued by WellCare Prescription Insurance, Inc.
