Wellcare Value Script (PDP)
Contract S4802, plan 136, segment 0 · offered by WELLCARE PRESCRIPTION INSURANCE, INC. · CMS PDP Region 01 (Maine).
Plan features
| Monthly premium | $0.00 |
|---|---|
| Annual deductible | $615.00Tier 1 and 2 exempt |
| Drug benefit type | — |
| $0 premium with full LIS | — |
| Premium with Extra Help (LIS) | — |
| Formulary drugs | 3,262 |
| Formulary exception tier | — |
| Plan reach | — |
| Members in Maine | 26,207 |
| Members nationally | 92,509 |
| Member services | (888)550-5252TTY 711 |
| Pharmacy search | go.wellcare.com/PDP |
| BIN / PCN | 610014 / MEDDPRIMESee BIN/PCNs for all plans |
CMS star ratings
- Part D summary rating
- 3.5 out of 5 stars for Part D summary rating
Published per contract, which is how CMS scores them — every plan under contract S4802 shares this rating.
Formulary tiers — preferred pharmacy, initial coverage phase
| Tier | Cost-sharing | Drugs on tier |
|---|---|---|
| Tier 1 | $0.00 | 362 |
| Tier 2 | $3.00 | 544 |
| Tier 3 | 25% | 364 |
| Tier 4 | 40% | 1,287 |
| Tier 5 | 25% | 689 |
| Tier 6 | $11.00 | 16 |
Cost-sharing by coverage phase
| Tier | 30-day supply | 90-day supply | ||||
|---|---|---|---|---|---|---|
| Preferred | Standard | Mail Order | Preferred | Standard | Mail Order | |
| Initial deductible phase | ||||||
| Tier 1: Preferred Generic | $0.00 | $15.00 | n/a | $0.00 | $45.00 | $0.00 |
| Tier 2: Generic | $3.00 | $20.00 | n/a | $9.00 | $60.00 | $9.00 |
| Initial coverage phase | ||||||
| Tier 1: Preferred Generic | $0.00 | $15.00 | n/a | $0.00 | $45.00 | $0.00 |
| Tier 2: Generic | $3.00 | $20.00 | n/a | $9.00 | $60.00 | $9.00 |
| Tier 3: Preferred Brand | 25% | 25% | n/a | 25% | 25% | 25% |
| Tier 4: Non-Preferred Drug | 40% | 50% | n/a | 40% | 50% | 40% |
| Tier 5: Specialty Tier | 25% | 25% | n/a | n/a | n/a | n/a |
| Tier 6: Select Care Drugs | $11.00 | $11.00 | n/a | $33.00 | $33.00 | $33.00 |
| Catastrophic coverage phase | ||||||
| Tier 1: Preferred Generic | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Tier 2: Generic | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Tier 3: Preferred Brand | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Tier 4: Non-Preferred Drug | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Tier 5: Specialty Tier | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
| Tier 6: Select Care Drugs | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
Plan facts come from the CMS quarterly prescription drug plan public use files.