2009 Medicare Prescription Drug Plan Details | |||||
---|---|---|---|---|---|
Medicare Plan Name: | MedicareRx Rewards Value by UniCare | ||||
State: | North Carolina | ||||
Plan ID: | S5960 - 008 - 0 Click to see other plans | ||||
Member Services: | 1-800-928-6201 TTY users 1-877-247-1657 | ||||
— This plan information is for research purposes only. — Click here to see plans for the current plan year | |||||
— This plan was sanctioned in 2009 — | |||||
Medicare Contact Information: | Please go to Medicare.gov or call 1-800-MEDICARE (1-800-633-4227) to get information on all of your options. TTY users 1-877-486-2048 or contact your local SHIP for assistance |
||||
Email a copy of the MedicareRx Rewards Value benefit details | |||||
— Medicare Plan Features — | |||||
Monthly Premium: | $36.70 | ||||
Annual Deductible: | $130 | ||||
$0 Premium if Full LIS Benefits? | No, this plan does NOT qualify for the $0 Premium. | ||||
Gap Coverage? | No Gap Coverage | ||||
Total Number of Formulary Drugs: | 3,708 drugs | Browse the MedicareRx Rewards Value Formulary | |||
This plan has 5 drug tiers. See cost-sharing highlights below. | |||||
Formulary Drug Details: | Tier 1 | Tier 2 | Tier 3 | Tier 4 | Tier 5 |
• Preferred Pharmacy Cost-Sharing during initial coverage phase: | $8.50 | $42.50 | $85.00 | 29% | 29% |
• Number of Drugs per Tier: | 1788 | 664 | 41 | 730 | 485 |
Plan Offers Mail Order? | Yes | ||||
Plan Type (Reach): | National Plan | ||||
Number of Members enrolled in this plan in North Carolina: | 3,758 members (CMS Region 08) | ||||
Number of Members enrolled in this plan nationally: | 79,859 members |