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Medicare Advantage and Prescription Drug Coverage

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    Part D

    Many Americans rely on prescription drugs to maintain their health and well-being. It’s important to consider whether you need a plan with prescription drug coverage.

    Medicare Advantage Prescription Drug (MAPD) are plans that combine medical coverage AND prescription drug coverage. Prescription Drug coverage (Part D) helps cover the cost of prescription drugs. To receive drug coverage, you have to purchase a Prescription Drug Plan (PDP) to add to your Original Medicare or enroll in a Medicare Advantage plan with Part D prescription drug coverage (MAPD).

    Prescription medications keep your health on track! WellCare MAPD plans save time and money with our mail-order pharmacy service with preferred cost-sharing. You can have your medications delivered right to your home, plus you may pay as little as $0 for a 90-day supply of many generic medications.

    1.

    Deductible

    The amount you pay before a plan covers your prescription drug costs, if applicable.

    2.

    Initial Coverage

    During this stage, the plan pays its share of the cost, and you pay your share. You are in this stage until your payments and the plan’s payments total $4,130 for the year.

    3.

    Coverage Gap

    When your drug costs and plan payments for the year reach $4,130, you enter the Coverage Gap Stage, commonly known as the "Donut Hole". In this stage, you will pay 25% of the cost for covered generic and brand-name drugs until your out-of-pocket costs for the year reach $6,550.

    4.

    Catastrophic Coverage

    After your out-of-pocket costs for prescription drugs reach $6,550, the plan will pay most of your drug costs for the rest of the year. You will pay either 5% of the cost of the drug, or a co-pay of $3.70 for generic drugs or $9.20 for all other drugs, whichever is greater.

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      • About Our Plans
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      WellCare Health Plans, Inc., is an HMO, PPO, PFFS plan with a Medicare contract. Our D-SNPs have contracts with State Medicaid programs. Enrollment in our plans depends on contract renewal. For accommodations of persons with special needs at meetings, call 1-877-MY-WELLCARE TTY 711. There is no obligation to enroll. Actual Part B Give Back dollar amount may vary by plan and county. You may enroll in the plan only during specific times of the year unless you qualify for a Special Election Period (SEP) or Initial Coverage Election Period (ICEP). Our plans use a formulary. Notice: TennCare is not responsible for payment for these benefits, except for appropriate cost sharing amounts. TennCare is not responsible for guaranteeing the availability or quality of these benefits. Free gift without obligation to enroll. By returning this card, you authorize a plan associate/contracted agent to call or contact you now or during the next enrollment when new benefits information is available. Every year, Medicare evaluates plans based on a 5-star rating system. Please contact your plan for details. Out-of-network/non-contracted providers are under no obligation to treat plan name members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services. You have the choice to sign up for automated mail service delivery. You can get prescription drugs shipped to your home through our network mail service delivery program. You should expect to receive your prescription drugs within 10–14 calendar days from the time that the mail service pharmacy receives the order. If you do not receive your prescription drugs within this time, please contact us at 1-866-808-7471 (TTY 711), 24 hours a day, seven days a week, or visit mailrx.wellcare.com.

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      Last Updated: 9/30/2020

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