MedicarePartD.guide

A non-government resource built from CMS public data

Wellcare Classic (PDP)

Contract S4802, plan 089, segment 0 · offered by WELLCARE PRESCRIPTION INSURANCE, INC. · CMS PDP Region 25 (South Dakota).

Plan features

Monthly premium$12.70
Annual deductible$615.00
Drug benefit type—
$0 premium with full LIS—
Premium with Extra Help (LIS)—
Formulary drugs2,988
Formulary exception tier—
Plan reach—
Members in South Dakotaat least 4,9448 counties suppressed by CMS (under 11 enrollees)
Members nationally65,834
Member services(888)550-5252TTY 711
Pharmacy searchwww.wellcare.com/PDP
BIN / PCN610014 / 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

TierCost-sharingDrugs on tier
Tier 1$0.00124
Tier 2$10.00396
Tier 325%665
Tier 427%1,114
Tier 525%689

Cost-sharing by coverage phase

Tier30-day supply90-day supply
PreferredStandardMail OrderPreferredStandardMail Order
Initial coverage phase
Tier 1: Preferred Generic$0.00$10.00n/a$0.00$30.00$0.00
Tier 2: Generic$10.00$20.00n/a$30.00$60.00$30.00
Tier 3: Preferred Brand25%25%n/a25%25%25%
Tier 4: Non-Preferred Drug27%27%n/a27%27%27%
Tier 5: Specialty Tier25%25%n/an/an/an/a
Catastrophic coverage phase
Tier 1: Preferred Generic0%0%0%0%0%0%
Tier 2: Generic0%0%0%0%0%0%
Tier 3: Preferred Brand0%0%0%0%0%0%
Tier 4: Non-Preferred Drug0%0%0%0%0%0%
Tier 5: Specialty Tier0%0%0%0%0%0%

Plan facts come from the CMS quarterly prescription drug plan public use files.