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2011 Medicare Prescription Drug Plan Cost-Sharing Details

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2011 Medicare Prescription Drug
Formulary (Drug List) Cost-Sharing Details
WellCare Signature (PDP) (S5967-042-0)
Benefit Details        
This plan is available in CMS PDP Region 8
Click on a letter below to view the
WellCare Signature (PDP) Formulary
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  30-Day Supply
Cost-Sharing
90-Day Supply
Cost-Sharing
Preferred Pharmacy Standard Pharmacy Mail- Order* Preferred Pharmacy Standard Pharmacy Mail- Order*
This plan does not have an Initial Deductible:n/an/an/an/an/an/a
Initial Coverage Phase Cost-Sharing
Tier 1: Generic: $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
Tier 2: Preferred Brand: $38.00 $38.00 $38.00 $114.00 $114.00 $95.00
Tier 3: Non-Preferred Brand: $70.00 $70.00 $70.00 $210.00 $210.00 $175.00
Tier 4: Specialty Tier: 33% 33% 33% n/a n/a n/a
Coverage Gap (Donut Hole) Phase Cost Sharing
Plan offers no Gap Coverage -- 7% Generic and 50% Brand Donut Hole Discount applies
All Formulary Generic Drugs: 93% 93% 93% 93% 93% 93%
All Formulary Brand-Name Drugs: 50% 50% 50% 50% 50% 50%
Catastrophic Coverage Phase Cost Sharing
Generic & Preferred Multi-Source Drugs: The greater of 5% or $2.50 The greater of 5% or $2.50
Other Drugs (Brand-Name or Non-Preferred Multi-Source Drugs): The greater of 5% or $6.30 The greater of 5% or $6.30
Go to the WellCare Signature (PDP) 2011 Formulary Browser by choosing a letter below:
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