Benefit Changes

PLAN #4000 PART D DRUG BENEFIT FOR 2026

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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

 

Senior Man Consulting Female Pharmacist Medication1

 

 

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 products25% coinsurance ($250 min, $500 max)25% coinsurance ($500 min, $1500 max)25% coinsurance ($500 min, $1500 max)

Catastrophic Coverage Stage: $0 Copayment