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2025 Medicare Prescription Drug Plan Cost-Sharing Details

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2025 Medicare Prescription Drug
Formulary (Drug List) Cost-Sharing Details
Wellcare Classic (PDP) (S4802-096-0)
Benefits & Contact Info        
all covered insulin pay $35 or less
This plan is available in CMS PDP Region 34
Click on a letter below to view the
Wellcare Classic (PDP) Formulary
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This Plan Uses Lower Cost-Sharing for Preferred Pharmacies
  30-Day Supply
Cost-Sharing
90-Day Supply
Cost-Sharing
Preferred Pharmacy Standard Pharmacy Mail- Order* Preferred Pharmacy Standard Pharmacy Mail- Order*
Initial Deductible Phase Cost Sharing
All Formulary Drug Tiers: 100% 100% 100% 100% 100% 100%
Initial Coverage Phase Cost-Sharing
Tier 1: Preferred Generic: $0.00 $3.00 $0.00 $0.00 $9.00 $0.00
Tier 2: Generic: $5.00 $8.00 $5.00 $15.00 $24.00 $15.00
Tier 3: Preferred Brand: 23% 23% 23% 23% 23% 23%
Tier 4: Non-Preferred Drug: 49% 49% 49% 49% 49% 49%
Tier 5: Specialty Tier: 25% 25% 25% n/a n/a n/a
Catastrophic Coverage Phase Cost Sharing
All Formulary Drugs:


$0 cost-sharing.
The Inflation Reduction Act (IRA) of 2022 eliminates beneficiary cost-sharing once your TrOOP reaches the established maximum cap on out-of-pocket spending for Part D formulary drugs (RxMOOP).
Go to the Wellcare Classic (PDP) 2025 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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