2025 prescription drug coverage phases
Medicare prescription payment plan
2025 prescription drug coverage phases
Initial Coverage Phase
Covered prescription drug costs are paid by the plan and the member. Senior Care Plus assigns a tier to each covered drug. This tier will dictate how much your cost share or co-pay will be. This information can be found in your Covered Drug List( Formulary). The Initial Coverage Stage ends when your total out-of-pocket costs for covered prescriptions reaches $ 2,000 paid.
Catastrophic Phase
In this phase Senior Care Plus pays 100 % of the cost for covered drugs. You, the member, will pay
$ 0 for all covered prescription drugs.
INITIAL COVERAGE PHASE CATASTROPHIC PHASE
• Covered prescription drug costs are paid by the plan and the member
• Senior Care Plus assigns a tier to each covered drug. This tier will dictate how much your cost share or co-pay will be. This information can be found in your Covered Drug List( Formulary).
• The Initial Coverage Stage ends when your total out-of-pocket costs for covered prescriptions reaches
$ 2,000 paid
PLAN PAYS 100 % of covered drug costs
MEMBER PAYS $ 0 for covered prescription drugs
Medicare prescription payment plan
The Medicare Prescription Payment Plan is a new payment option that requires Medicare Advantage plans like Senior Care Plus to provide members the option to pay out-of-pocket prescription drug costs in the form of monthly payments over the course of the plan year instead of all at once to the pharmacy.
What that means is, members will have the option to pay drug costs in the form of capped monthly installments instead of paying each time at the pharmacy counter.
Think of it like a level pay plan – instead of paying at the pharmacy, you will receive a monthly bill for any cost sharing you incur while in the program.
Any Senior Care Plus member with Part D prescription drug benefits will be eligible to opt into the program regardless of low-income status and / or prior challenges with premium payment.
For those that do opt in, you will pay $ 0 at the pharmacy counter and the financed member cost share immediately contributes to Part D out-of-pocket accumulators.
Contact Renown Pharmacy at 775-982-7737 to learn more. – 20 –