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Medicare Prescription Drug Plan Cost-Sharing Details
This is archive material for research purposes. Please see PDPFinder.com or MAFinder.com for current plans.
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2012 Medicare Prescription Drug
Formulary (Drug List) Cost-Sharing Details
WellCare Signature (PDP) (S5967-047-0)
Benefit Details        
This plan is available in CMS PDP Region 13
Click on a letter below to view the
WellCare Signature (PDP) Formulary
A  B  C  D  E  F  G  H  I  J  K  L  M  N  O  P  Q  R  S  T  U  V  W  X  Y  Z  0-9 
  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: Preferred Generic Drugs: $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
Tier 2: Non-Preferred Generic Drugs: $20.00 $20.00 $20.00 $60.00 $60.00 $50.00
Tier 3: Preferred Brand Drugs: $45.00 $45.00 $45.00 $135.00 $135.00 $112.50
Tier 4: Non-Preferred Brand Drugs: $95.00 $95.00 $95.00 $285.00 $285.00 $237.50
Tier 5: Specialty Tier Drugs: 33% 33% 33% n/a n/a n/a
Coverage Gap (Donut Hole) Phase Cost Sharing
Plan offers no Gap Coverage -- 14% Generic and 50% Brand Donut Hole Discount applies
All Formulary Generic Drugs: 86% 86% 86% 86% 86% 86%
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 $2.60 The greater of 5% or $2.60
Other Drugs (Brand-Name or Non-Preferred Multi-Source Drugs): The greater of 5% or $6.50 The greater of 5% or $6.50
Go to the WellCare Signature (PDP) 2012 Formulary Browser by choosing a letter below:
A  B  C  D  E  F  G  H  I  J  K  L  M  N  O  P  Q  R  S  T  U  V  W  X  Y  Z  0-9 
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