Benefit Changes

2020 BENEFIT CHANGES

Plan #4000 Supplement to Medicare Parts A & B with Part D Coverage Dues Rate for 2020: $325.00 monthly ($975.00 quarterly)

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PRESCRIPTION DRUG BENEFIT FOR PLAN YEAR 2020

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 2020 will have a yearly deductible of $300 and the Initial Coverage Limit will be increased to $4,020.

The copayments for Plan Year 2020 have changed slightly (see chart below).

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 $4,020
  • Prescription Drug Benefit $6,350

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 2020 are listed below.

Open enrollment is from October 30th through Novemb 18th. 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 2020. For questions regarding your prescription drug benefit contact the CARE Customer Service Department at 1.800.334.1330.

Navitus MedicareRx (PDP) Summary of Benefits 2020

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 $4,020, when you move onto the Gap Coverage Stage.

Cost Sharing TiersNetwork 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 products25% 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 $6,350 for Part D drugs, you pay the greater of either 5% coinsurance OR a $3.60 copay for a generic drug (including brand drugs treated as generic) OR a $8.95 copay for all other drugs.

2019 Benefit Changes

ENROLLMENT BENEFIT CHANGE

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 indefinitely.

CARE PLAN #4000 - PRESCRIPTION DRUG BENEFIT (PART D) CHANGE FOR 2019:

For Plan Year 2019, Express Scripts Medicare (PDP) will continue to administer pharmacy benefits for our Plan #4000 members.

  • Annual deductible of $300
  • Initial Coverage Limit increased from $3,750 to $3,820
  • Prescription Drug Benefit increase from $5,000 to $5,100

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 2019 are listed below.

Open enrollment is from October 15th through December 7th. 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 2019. For questions regarding your prescription drug benefit contact the CARE Customer Service Department at 1.800.334.1330.

CARE PLAN #4000 RX BENEFIT FOR 2019

Initial Coverage StageDeductible
$0 - $3,820After you have met your annual deductible of $300 you will pay the applicable copayment/coinsurance listed below until your total drug costs reach $3,820.
Coverage Gap Stage $3,820 - $5,100
After your total drug costs reach $3,820, you will continue to pay the same applicable copayment and/or coinsurance listed below as in the Initial Coverage Stage until you reach $5,100.
Catastrophic Coverage Stage > Greater than $5,100
After your out-of-pocket drug costs reach $5,100, you will pay the greater of 5% coinsurance or $3.40 for generics (or drugs treated as generic) and $8.50 for all other drugs. The Plan will pay the rest.
TIERSUp to 31-Day Supply (RETAIL)32 to 90-Day Supply (RETAIL)90-Day Supply (MAIL ORDER)
Tier 1: Generic Drugs (lower cost)$15 COPAYMENT$15 COPAYMENT$15 COPAYMENT
Tier 2: Preferred Brand Drugs$40 COPAYMENT$120 COPAYMENT$100 COPAYMENT
Tier 3: Non-Preferred Brand Drugs$60 COPAYMENT$180 COPAYMENT$150 COPAYMENT
Tier 4: Specialty Drugs33% of drug costs. $450 Maximum33% of drug costs. $1,350 Maximum33% of drug costs. $750 Maximum