Benefit Changes
PLAN #4000 PART D DRUG BENEFIT FOR 2026

Plan #4000 Part D Drug Benefit for 2026: Navitus MedicareRx (PDP) will continue to administer pharmacy benefits for this plan and CARE will continue to provide you with an “enhanced” Part D prescription drug benefit. The copayments for Plan Year 2026 will remain the same as Plan Year 2025.
- Annual Deductible: $300
During this stage the member pays 100% of drug costs. After you have met your annual deductible of $300, you will pay the applicable copayment / coinsurance until your total drug costs reach the new Out-of-Pocket amount of $2,100.
- Initial Coverage: $300 - $2,100
After you meet your deductible, your plan will help pay for your covered prescription drugs. Your plan will pay some of the cost, and you will pay a copayment or coinsurance. Any amounts paid toward your deductible, as well as copayments / coinsurance paid for your Medicare-covered prescription drugs will go towards the Out-of-Pocket maximum of $2,100.
- Catastrophic Coverage: $0 copay for covered Part D drugs
Navitus MedicareRx (PDP) Summary of Benefits 2026
Annual Deductible Stage: After you have met your annual deductible of $300, you will pay the full cost of your Part D drugs (applicable copayment/coinsurance listed below) until your total drug costs reach the new Out-of-Pocket amount of $2,100.
Initial Coverage Stage: Any amounts paid toward your annual deductible, as well as copayments/coinsurance paid for your Medicare-covered prescription drugs will go towards the Out-of-Pocket maximum.
| 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) |
Catastrophic Coverage Stage: $0 Copayment