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2025 Medicare Prescription Drug Plan Benefit Details for the Wellcare Value Script (PDP) - S4802-135


2025 Medicare Prescription Drug Plan Details
Medicare Plan Name:Wellcare Value Script (PDP)
   by Wellcare
State:Oregon
Plan ID:S4802 - 135 - 0     Click to see other plans
Member Services:(888)550-5252 TTY users 711
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 Wellcare Value Script (PDP) benefit details
— Medicare Plan Features —
Monthly Premium:$0.00 (see Plan Premium Details below)
Annual Deductible:$590 (Tier 1 and 2 excluded from the Deductible.)
$0 Premium if LIS Benefits?No, this plan does NOT qualify for the $0 Premium. (See premium for LIS subsidy beneficiaries below.)
Drug Benefit Type Enhanced Alternative (EA)
Total Number of Formulary Drugs:3,272 drugsBrowse the Wellcare Value Script (PDP) Formulary
Formulary Exception Tier:Tier 4 If your formulary exception request is approved, your drug will be placed on this tier.
This plan has 5 drug tiers. See cost-sharing for all pharmacies and tiers
Insulin on a Medicare Part D plan's formulary will have a monthly copay of $35 or less.
Formulary Drug Details:Tier 1Tier 2Tier 3Tier 4Tier 5
Preferred Pharmacy
  Cost-Sharing during
  initial coverage phase:
$0.00$5.0025%42%25%
Number of Drugs per
  Tier:
3536363351282666
Plan's Pharmacy Search:http://www.wellcare.com/PDP
Plan Offers Mail Order?Yes
Plan Type (Reach):National Plan
Number of Members enrolled in this plan in your CMS Region:119,065 members     (CMS Region 30)
Number of Members enrolled in this plan nationally:4,073,221 members
Plan’s Summary Star Rating: 3.5 out of 5 Stars.
Customer Service Rating: 4 out of 5 Stars.
Member Experience Rating: 3 out of 5 Stars.
Drug Cost Accuracy Rating: 3 out of 5 Stars.
— Plan Premium Details —
The Monthly Premium is Split as Follows:
Total
Premium
Part D Basic
Premium
Part D Supplemental
Premium
$0.00$-13.50$13.50
Monthly Premium with Extra Help Low-Income Subsidy (LIS): $0.00





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