PRESCRIPTION DRUG BENEFIT FOR PLAN YEAR 2022
Navitus MedicareRx (PDP) will administer pharmacy benefits for our Plan #4000 members. CARE will continue to provide you with an “enhanced” Part D
Part D prescription drug benefit. Your drug benefit for 2022 will have a yearly deductible of $300 and the Initial Coverage Limit will be increased to $4,430.
The copayments for Plan Year 2022 will remain the same.
Members currently enrolled in Plan #4000 have the option of transferring to Plan #4100. However, please be advised that Plan #4000 members who choose to transfer to Plan #4100 WILL NOT have the option of returning to Plan #4000 once they have made the decision to leave the plan, as enrollment in Plan #4000 has been suspended.
- Annual deductible of $300
- Initial Coverage Limit $4,430
- Prescription Drug Benefit $7,050
CARE will continue to provide you with an "enhanced" Part D prescription drug benefit with no coverage gap known as the "Donut Hole." Your copayments and a brief summary of your prescription drug benefit for Plan Year 2022 are listed below.
Open enrollment is from October 15th through December 7th, 2021. The benefit period for Plan #4000 is January 1 through December 31. Please see the chart below for further explanation of the stages plus your copayments for 2022. For questions regarding your prescription drug benefit contact the CARE Customer Service Department at 1.800.334.1330.
Navitus MedicareRx (PDP) Summary of Benefits 2022
Yearly Deductible Stage: During this stage, you pay the full cost of your Part D Drugs. You stay in this stage until you have paid your $300 yearly deductible amount. Once you have paid your deductible amount you move onto the Initial Coverage Stage.
Initial Coverage Stage: During this stage, the plan pays its share for the cost of your drugs and you pay your share of the cost. The table below shows your share of the cost for drugs in each of the plan’s drug tiers. You stay in this stage until the total costs of your Part D drugs reach $4,430, when you move onto the Gap Coverage Stage.
|Cost Sharing Tiers||Network Retail Pharmacy (1-31 day supply)||Network Retail Pharmacy (32 - 90 day supply)||Mail Order Pharmacy (Up to 90-day supply)|
|Tier 1: Generic products||$15 copayment||$15 copayment||$15 copayment|
|Tier 2: Preferred brand products||$40 copayment||$120 copayment||$100 copayment|
|Tier 3: Non-preferred brand products||$60 copayment||$180 copayment||$150 copayment|
|Tier 4: Specialty products||25% coinsurance ($250 min, $500 max)||25% coinsurance ($500 min, $1500 max)||25% coinsurance ($500 min, $1500 max)|
Gap Coverage Stage: During this stage, you will continue to pay the same cost sharing amount as in the Initial Coverage Stage.
Catastrophic Coverage Stage: After your out-of-pocket drug costs reach $7,050 for Part D drugs, you pay the greater of either 5% coinsurance OR a $3.95 copay for a generic drug (including brand drugs treated as generic) OR a $9.85 copay for all other drugs.