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2014 Medicare Part D and Medicare Advantage Plan Formulary Browser
This is archive material for research purposes. Please see PDPFinder.com or MAFinder.com for current plans.
Select your search style and criteria below or use this example to get started

Search by:
State & Plan   ZIP & Plan   PlanID   FormularyID

Search Criteria
PDP     MAPD
Scroll down to see formulary results.

Blue Rx Plus (PDP) (S5593-002-0)
Tier 1 (666)
Tier 2 (1604)
Tier 3 (502)
Tier 4 (1308)
Tier 5 (426)
Requires Prior Authorization:
Yes No Show either
Uses Step Therapy:
Yes No Show either
Has Quantity Limits:
Yes No Show either
  *required
 
Cick on the first letter of your drug name to browse the 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 
2014 Medicare Part D Plan Formulary Information
Blue Rx Plus (PDP) (S5593-002-0)
Benefit Details           
The Blue Rx Plus (PDP) (S5593-002-0)
Formulary Drugs Starting with the Letter Z
in CMS PDP Region 6 which includes: PA WV
Plan Monthly Premium: $74.30 Deductible: $310 Qualifies for LIS: No
Drugs Starting with Letter Z

Drug Name		 Drug Tier Information Cost-Sharing Drug
Usage
Mgmt
Tier
Nbr.		 Tier
Description		 30-Day
Preferred
Pharm		 90-Day
Mail
Order
ZAFIRLUKAST 10MG TABLETS   2 Non-Preferred Generic $11.00$27.50None
ZAFIRLUKAST 20MG TABLETS   2 Non-Preferred Generic $11.00$27.50None
ZALEPLON 10MG CAPSULE   2 Non-Preferred Generic $11.00$27.50None
ZALEPLON 5MG CAPSULE   2 Non-Preferred Generic $11.00$27.50None
ZALTRAP 100 MG/4 ML VIAL   5 Specialty Tier 25%25%None
ZAMICET SOLN 325MG; 10MG/15ML   2 Non-Preferred Generic $11.00$27.50Q:5723
/31Days
ZANOSAR 1GM VIAL   4 Non-Preferred Brand 50%50%None
ZANTAC 150MG TABLET   4 Non-Preferred Brand 50%50%None
ZANTAC 15MG/ML SYRUP   4 Non-Preferred Brand 50%50%None
ZANTAC 25 MG/ML VIAL   4 Non-Preferred Brand 50%50%None
Drug Name Tier
Nbr.		 Tier
Description		 30-Day
Preferred
Pharm		 90-Day
Mail
Order		 Drug
Usage
Mgmt
ZANTAC 300MG TABLET   4 Non-Preferred Brand 50%50%None
ZARONTIN 250MG CAPSULE   4 Non-Preferred Brand 50%50%None
ZARONTIN 250MG/5ML SYRUP   4 Non-Preferred Brand 50%50%None
ZAVESCA 100MG CAPSULE   5 Specialty Tier 25%25%None
ZAZOLE 0.4% CREAM WITH APPLICATOR   2 Non-Preferred Generic $11.00$27.50None
ZAZOLE 0.8% CREAM WITH APPLICATOR   4 Non-Preferred Brand 50%50%None
ZELAPAR 1.25MG ODT TABLET   4 Non-Preferred Brand 50%50%None
ZELBORAF 240mg/1 1 BOTTLE, PLASTIC per CARTON / 120 FILM COATED TABLETS in BOTTLE, PLASTIC   5 Specialty Tier 25%25%P
ZEMAIRA 1000MG VIAL   5 Specialty Tier 25%25%P
ZEMPLAR 1 MCG CAPSULE   4 Non-Preferred Brand 50%50%P
ZEMPLAR 2 MCG CAPSULE   4 Non-Preferred Brand 50%50%P
Drug Name Tier
Nbr.		 Tier
Description		 30-Day
Preferred
Pharm		 90-Day
Mail
Order		 Drug
Usage
Mgmt
Zemplar 2ug/mL 25 VIAL, SINGLE-DOSE in 1 TRAY / 1 mL in 1 VIAL, SINGLE-DOSE   4 Non-Preferred Brand 50%50%P
ZEMPLAR 4 MCG CAPSULE   4 Non-Preferred Brand 50%50%P
Zemplar 5ug/mL 25 VIAL, MULTI-DOSE in 1 TRAY / 2 mL in 1 VIAL, MULTI-DOSE   4 Non-Preferred Brand 50%50%P
ZENCHENT FE TABLET CHEWABLE   2 Non-Preferred Generic $11.00$27.50None
ZENPEP 109000; 20000; 68000 DELAYED RELEASE 100 CAPSULE BOTTLE   3 Preferred Brand 25%25%None
ZENPEP 27000; 5000; 17000 DELAYED RELEASE 100 CAPSULE BOTTLE   3 Preferred Brand 25%25%None
ZENPEP 55000; 10000; 34000 DELAYED RELEASE 100 CAPSULE BOTTLE   3 Preferred Brand 25%25%None
ZENPEP 82000; 15000; 51000 DELAYED RELEASE 100 CAPSULE BOTTLE   3 Preferred Brand 25%25%None
ZENPEP DR 25,000 UNITS CAPSULE   3 Preferred Brand 25%25%None
ZENPEP DR 3,000 UNITS CAPSULE   3 Preferred Brand 25%25%None
ZENZEDI 10 MG TABLET   2 Non-Preferred Generic $11.00$27.50None
Drug Name Tier
Nbr.		 Tier
Description		 30-Day
Preferred
Pharm		 90-Day
Mail
Order		 Drug
Usage
Mgmt
ZENZEDI 15 MG TABLET   4 Non-Preferred Brand 50%50%None
ZENZEDI 2.5 MG TABLET   4 Non-Preferred Brand 50%50%None
ZENZEDI 20 MG TABLET   4 Non-Preferred Brand 50%50%None
ZENZEDI 30 MG TABLET   4 Non-Preferred Brand 50%50%None
ZENZEDI 5 MG TABLET   2 Non-Preferred Generic $11.00$27.50None
ZENZEDI 7.5 MG TABLET   4 Non-Preferred Brand 50%50%None
ZERIT 15MG CAPSULE   4 Non-Preferred Brand 50%50%None
ZERIT 1MG/ML SOLUTION   4 Non-Preferred Brand 50%50%None
ZERIT 20MG CAPSULE   4 Non-Preferred Brand 50%50%None
ZERIT 30MG CAPSULE   4 Non-Preferred Brand 50%50%None
ZERIT 40MG CAPSULE   4 Non-Preferred Brand 50%50%None
Drug Name Tier
Nbr.		 Tier
Description		 30-Day
Preferred
Pharm		 90-Day
Mail
Order		 Drug
Usage
Mgmt
ZETIA 10MG TABLET (90 CT)   3 Preferred Brand 25%25%None
ZIAGEN 20mg/mL 240 mL in 1 BOTTLE   3 Preferred Brand 25%25%None
ZIAGEN 300mg/1 60 FILM COATED TABLETS in BOTTLE   4 Non-Preferred Brand 50%50%None
ZIDOVUDINE 100MG CAPSULE   2 Non-Preferred Generic $11.00$27.50None
ZIDOVUDINE 10MG/ML SYRUP   2 Non-Preferred Generic $11.00$27.50None
Zidovudine 300mg/1 12 BOTTLE CASE / 60 TABLET BOTTLE   2 Non-Preferred Generic $11.00$27.50None
ZINECARD 250 MG VIAL   4 Non-Preferred Brand 50%50%None
ZIOPTAN 0.0015% EYE DROPS   4 Non-Preferred Brand 50%50%None
ZIPRASIDONE HCL 20 MG CAPSULE [Geodon]   1 Preferred Generic $0.00$0.00None
ZIPRASIDONE HCL 40 MG CAPSULE [Geodon]   1 Preferred Generic $0.00$0.00None
ZIPRASIDONE HCL 60 MG CAPSULE [Geodon]   1 Preferred Generic $0.00$0.00None
Drug Name Tier
Nbr.		 Tier
Description		 30-Day
Preferred
Pharm		 90-Day
Mail
Order		 Drug
Usage
Mgmt
ZIPRASIDONE HCL 80 MG CAPSULE [Geodon]   1 Preferred Generic $0.00$0.00None
ZIRGAN 1.5mg/g 1 TUBE, WITH APPLICATOR per CARTON / 5 g in 1 TUBE, WITH APPLICATOR   4 Non-Preferred Brand 50%50%None
ZITHROMAX 250MG TABLET   4 Non-Preferred Brand 50%50%None
ZITHROMAX 250MG Z-PAK TABLET   4 Non-Preferred Brand 50%50%None
ZITHROMAX 500MG TABLET   4 Non-Preferred Brand 50%50%None
ZITHROMAX 600MG TABLET   4 Non-Preferred Brand 50%50%None
ZITHROMAX IV 500MG VIAL 10 VIAL BOX   4 Non-Preferred Brand 50%50%None
ZITHROMAX ORAL SUSP 100MG/5ML   4 Non-Preferred Brand 50%50%None
ZITHROMAX ORAL SUSP 200MG/5ML   4 Non-Preferred Brand 50%50%None
ZITHROMAX TRI-PAK 500MG TABLET   4 Non-Preferred Brand 50%50%None
ZMAX 2g/60mL 60 mL in 1 BOTTLE   4 Non-Preferred Brand 50%50%None
Drug Name Tier
Nbr.		 Tier
Description		 30-Day
Preferred
Pharm		 90-Day
Mail
Order		 Drug
Usage
Mgmt
ZOFRAN 2MG/ML MDV VIAL   4 Non-Preferred Brand 50%50%None
ZOFRAN 4mg/1 30 FILM COATED TABLETS in BOTTLE   5 Specialty Tier 25%25%None
ZOFRAN 4MG/5ML ORAL TUBEX   5 Specialty Tier 25%25%None
ZOFRAN 8 MG TABLET   5 Specialty Tier 25%25%None
ZOFRAN ODT 4MG TABLET   4 Non-Preferred Brand 50%50%None
ZOFRAN ODT 8mg/1 30 TABLET, ORALLY DISINTEGRATING in 1 DOSE PACK   5 Specialty Tier 25%25%None
ZOHYDRO ER 10 MG CAPSULE   4 Non-Preferred Brand 50%50%Q:100
/31Days
ZOHYDRO ER 15 MG CAPSULE   4 Non-Preferred Brand 50%50%Q:100
/31Days
ZOHYDRO ER 20 MG CAPSULE   4 Non-Preferred Brand 50%50%Q:100
/31Days
ZOHYDRO ER 30 MG CAPSULE   4 Non-Preferred Brand 50%50%Q:100
/31Days
ZOHYDRO ER 40 MG CAPSULE   4 Non-Preferred Brand 50%50%Q:100
/31Days
Drug Name Tier
Nbr.		 Tier
Description		 30-Day
Preferred
Pharm		 90-Day
Mail
Order		 Drug
Usage
Mgmt
ZOHYDRO ER 50 MG CAPSULE   4 Non-Preferred Brand 50%50%Q:100
/31Days
Zoledronic Acid 4 mg/5 ml vial   2 Non-Preferred Generic $11.00$27.50None
zoledronic acid 5 mg/100 ml   2 Non-Preferred Generic $11.00$27.50None
ZOLINZA 100MG CAPSULE   5 Specialty Tier 25%25%P
ZOLMITRIPTAN 2.5 MG ODT [Zomig, Zomig-ZMT]   2 Non-Preferred Generic $11.00$27.50Q:16
/31Days
ZOLMITRIPTAN 2.5 MG TABLET [Zomig, Zomig-ZMT]   2 Non-Preferred Generic $11.00$27.50Q:16
/31Days
ZOLMITRIPTAN 5 MG ODT [Zomig, Zomig-ZMT]   2 Non-Preferred Generic $11.00$27.50Q:8
/31Days
ZOLMITRIPTAN 5 MG TABLET [Zomig, Zomig-ZMT]   2 Non-Preferred Generic $11.00$27.50Q:8
/31Days
ZOLPIDEM TART ER 12.5 MG TAB   2 Non-Preferred Generic $11.00$27.50None
ZOLPIDEM TARTRATE 10MG TABLETS   2 Non-Preferred Generic $11.00$27.50None
Zolpidem Tartrate 5mg/1 100 FILM COATED TABLETS in BOTTLE   2 Non-Preferred Generic $11.00$27.50None
Drug Name Tier
Nbr.		 Tier
Description		 30-Day
Preferred
Pharm		 90-Day
Mail
Order		 Drug
Usage
Mgmt
ZOLPIDEM TARTRATE 6.25MG TABLETS EXTENDED RELEASE   2 Non-Preferred Generic $11.00$27.50None
Zometa 4mg/100mL 1 BOTTLE per CARTON / 100 mL in 1 BOTTLE   5 Specialty Tier 25%25%None
ZOMETA 4MG/5ML VIAL   5 Specialty Tier 25%25%None
ZOMIG 2.5 MG NASAL SPRAY   4 Non-Preferred Brand 50%50%Q:16
/31Days
ZOMIG 2.5 MG TABLET   4 Non-Preferred Brand 50%50%Q:16
/31Days
ZOMIG 5 MG NASAL SPRAY   4 Non-Preferred Brand 50%50%Q:8
/31Days
ZOMIG 5 MG TABLET   4 Non-Preferred Brand 50%50%Q:8
/31Days
ZOMIG ZMT 2.5 MG TABLET   4 Non-Preferred Brand 50%50%Q:16
/31Days
ZOMIG ZMT 5 MG TABLET   4 Non-Preferred Brand 50%50%Q:8
/31Days
ZONALON 5% CREAM   4 Non-Preferred Brand 50%50%None
ZONEGRAN 100MG CAPSULE   4 Non-Preferred Brand 50%50%None
Drug Name Tier
Nbr.		 Tier
Description		 30-Day
Preferred
Pharm		 90-Day
Mail
Order		 Drug
Usage
Mgmt
ZONEGRAN 25MG CAPSULE   4 Non-Preferred Brand 50%50%None
ZONISAMIDE 100MG CAPSULE (100 CT)   2 Non-Preferred Generic $11.00$27.50None
Zonisamide 25mg 100 CAPSULE BOTTLE   2 Non-Preferred Generic $11.00$27.50None
ZONISAMIDE 50MG CAPSULE (100 CT)   2 Non-Preferred Generic $11.00$27.50None
ZONTIVITY 2.08 MG TABLET   4 Non-Preferred Brand 50%50%None
Zorbtive 8.8mg/mL 1 INJECTION, POWDER, FOR SOLUTION per CARTON   5 Specialty Tier 25%25%P
ZORTRESS 0.25MG TABLETS   4 Non-Preferred Brand 50%50%P
Zortress 0.5mg/1 60 BLISTER PACK in 1 BOX / 1 TABLET per BLISTER PACK   4 Non-Preferred Brand 50%50%P
Zortress 0.75mg/1 60 BLISTER PACK in 1 BOX / 1 TABLET per BLISTER PACK   5 Specialty Tier 25%25%P
ZOSTAVAX VIAL   3 Preferred Brand 25%25%None
ZOSYN 2/0.25GM PRE-MIX BAG   3 Preferred Brand 25%25%None
Drug Name Tier
Nbr.		 Tier
Description		 30-Day
Preferred
Pharm		 90-Day
Mail
Order		 Drug
Usage
Mgmt
Zosyn 3.0; 0.375g/15mL; g/15mL 10 VIAL, SINGLE-USE per CARTON / 3.375 mL in 1 VIAL, SINGLE-USE   4 Non-Preferred Brand 50%50%None
ZOSYN 3/0.375GRAM 24 BAGS PKG   3 Preferred Brand 25%25%None
ZOVIA 1/35-28 TABLET   2 Non-Preferred Generic $11.00$27.50None
ZOVIA 1/50-28 TABLET   2 Non-Preferred Generic $11.00$27.50None
ZOVIRAX 200MG CAPSULE   4 Non-Preferred Brand 50%50%None
ZOVIRAX 200MG/5ML ORAL SUSP   4 Non-Preferred Brand 50%50%None
ZOVIRAX 400MG TABLET   4 Non-Preferred Brand 50%50%None
ZOVIRAX 5% CREAM   3 Preferred Brand 25%25%None
ZOVIRAX 5% OINTMENT   3 Preferred Brand 25%25%None
ZYBAN 150MG TABLET SA   4 Non-Preferred Brand 50%50%None
ZYCLARA 2.5% CREAM PUMP   4 Non-Preferred Brand 50%50%None
Drug Name Tier
Nbr.		 Tier
Description		 30-Day
Preferred
Pharm		 90-Day
Mail
Order		 Drug
Usage
Mgmt
ZYCLARA 3.75% CREAM   4 Non-Preferred Brand 50%50%None
ZYFLO 600 MG FILMTAB (120 TABLETS)   4 Non-Preferred Brand 50%50%P
ZYFLO CR 600 MG TABLET   4 Non-Preferred Brand 50%50%P
ZYKADIA 150 MG CAPSULE   5 Specialty Tier 25%25%P
ZYLET 0.3%-0.5% SUSPENSION DROPS(FINAL DOSAGE FORM)(ML)   4 Non-Preferred Brand 50%50%None
ZYLOPRIM 100MG TABLET   4 Non-Preferred Brand 50%50%None
ZYLOPRIM 300 MG TABLET   4 Non-Preferred Brand 50%50%None
ZYMAXID 5mg/mL 1 BOTTLE, DROPPER per CARTON / 2.5 mL in 1 BOTTLE, DROPPER   3 Preferred Brand 25%25%None
Zytiga 250mg/1 120 TABLET BOTTLE   5 Specialty Tier 25%25%P
ZYVOX 100MG/5ML SUSPENSION   5 Specialty Tier 25%25%None
ZYVOX 600MG TABLET   5 Specialty Tier 25%25%None
Drug Name Tier
Nbr.		 Tier
Description		 30-Day
Preferred
Pharm		 90-Day
Mail
Order		 Drug
Usage
Mgmt
ZYVOX 600MG/300ML IV SOLUTION   5 Specialty Tier 25%25%None

Chart Legend:

Below are a few notes to help you understand the above 2014 Medicare Part D Blue Rx Plus (PDP) Plan Formulary.
  • Plan Name: This is the official Medicare Part D prescription drug plan name from the Centers for Medicare and Medicaid Services (CMS). The same Medicare Part D plan name generally has a different Plan ID in each state (or CMS Region).

  • Monthly Premium: This is the amount you must pay each month for this prescription drug plan. This monthly premium must be paid even if you are in the initial deductible phase or the coverage gap (donut hole) phase.

  • Deductible: If your Part D plan has an initial deductible, you are 100% responsible for your drug costs until your expenses exceed this value and you begin your Initial Coverage Phase. Many Medicare Part D plans use the standard $310 deductible as provided by CMS in their Standard plan design. Some Part D plan providers offer an initial deductible lower than the Standard deductible. Many prescription drug plans do not have a deductible (also called first dollar coverage or a $0 deductible), however the monthly premium for a plan with a $0 deductible may be slightly higher.

  • Qualifies for LIS: The Extra Help or Low Income Subsidy (LIS) Program.
    • Yes - This plan qualifies for the $0 Premium for those persons with a full LIS or Extra Help benefit. Persons on the LIS program who select a qualifying plan will also pay a $0 deductible, pay lower cost-sharing payments and have coverage through the Coverage Gap or Doughnut Hole.

    • No - This plan does not qualify for the $0 Premium for persons with the full LIS benefit.

  • Plan ID: This is the Medicare Part D prescription drug plan's unique ID.
  • Drug Tier Information - Drug Tiers are the logical grouping of prescription drugs on a Part D plan formulary. These fields represent the Tier (or drug list group) - for this particular medication - on this particular plan’s Formulary or Drug List.
    • Tier Number - This is the actual numerical tier level from the formulary. Most Part D plans have four (4) tiers 1=Preferred Generics, 2=Preferred Brands, 3=Non-preferred Brands and Generics, 4=Specialty Drugs.
    • Drug Description - This is the Medicare Part D plan’s description of this particular drug tier.
  • Cost Sharing - Copay / Coinsurance - These figures apply to the initial coverage phase of your plan. This is the phase after the initial deductible has been met and before you reach the Coverage Gap (Donut Hole). Plans often cover drugs in "tiers". Tiers are specific to the list of drugs covered by the plan. Plans may have several tiers, and the copay for a drug depends on the drug’s tier. The drug Tier is shown to the left of this column. These cost sharing figures DO NOT necessarily apply to the Coverage Gap. The plan may have a separate copay/coinsurance for the same drug while in the Coverage Gap. There are two figures shown under this "Cost Sharing" category:
    • Preferred Network Pharmacy - (Preferred Pharm) - This is the cost-share amount you would pay during the intial coverage phase for a 30-Day supply (until your total retail prescription drug costs reach $2850) at a "Preferred" network pharmacy. In most cases, the "Preferred" network and network pharmacy pricing are the same. However, for example on the 2014 Humana Walmart-Preferred Rx Plan the cost-sharing is much higher at a network pharmacy over a "Preferred" network pharmacy. "Preferred" network pharmacies for this plan include only Walmart, Sam’s Club and RightSource.
    • Mail Order - This is the cost-share amount you would pay during the initial coverage phase for a 90-Day supply if you purchased your medication through your plan’s preferred mail order partner(s).
  • Drug Utilization Management or Coverage Rules - (Drug Usage Mgmt) - This shows the plan requires drug utilization management controls for this particular medication.
    • None - This drug does not fall under any drug utilization management controls.
    • P - Prior Authorization -This drug is subject to prior authorization.
    • S - Step Therapy -This drug is subject to step therapy.
    • Q - Quantity Limits -This drug is subject to quantity limits. The actual quantity limit is shown as Q:Amount/Days. For Example: Q:6/28Days means the quantity limit is a quantity of 6 pills per 28 days. Q:90/365Days would mean that the plan limits this drug to 90 pills for the entire year.




(Chart Source: Centers for Medicare and Medicaid files: CMS Data September 2014 )

Please note: The above plan information comes from CMS. We make every attempt to keep our information up-to-date with plan/premium changes. However, the Medicare Part D plan data changes over time and we cannot guarantee the accuracy of this information. You should always verify cost and coverage information with your Part D plan provider.





 
 


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Tips & Disclaimers
  • Q1Medicare®, Q1Rx®, and Q1Group® are registered Service Marks of Q1Group LLC and may not be used in any advertising, publicity, or for commercial purposes without the express authorization of Q1Group.
  • The Medicare Advantage and Medicare Part D prescription drug plan data on our site comes directly from Medicare and is subject to change.
  • Medicare has neither reviewed nor endorsed the information on our site.
  • We provide our Q1Medicare.com site for educational purposes and strive to present unbiased and accurate information. However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. For more information on your Medicare coverage, please be sure to seek legal, medical, pharmaceutical, or financial advice from a licensed professional or telephone Medicare at 1-800-633-4227.
  • We are an independent education, research, and technology company. We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. We are not compensated for Medicare plan enrollments. We do not sell leads or share your personal information.
  • Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. Our PDPCompare.com and MACompare.com provide highlights of annual plan benefit changes.
  • The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan.
  • Limitations, copayments, and restrictions may apply.
  • We make every effort to show all available Medicare Part D or Medicare Advantage plans in your service area. However, since our data is provided by Medicare, it is possible that this may not be a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.
    Statement required by Medicare:
    "We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options."
  • When enrolling in a Medicare Advantage plan, you must continue to pay your Medicare Part B premium.
  • Medicare beneficiaries with higher incomes may be required to pay both a Medicare Part B and Medicare Part D Income Related Monthly Adjustment Amount (IRMAA). Read more on IRMAA.
  • Medicare Advantage plans that include prescription drug coverage (MAPDs) are considered Medicare Part D plans and members with higher incomes may be subject to the Medicare Part D Income Related Monthly Adjustment Amount (IRMAA), just as members in stand-alone Part D plans. In certain situations, you can appeal IRMAA.
  • You must be enrolled in both Medicare Part A and Part B to enroll in a Medicare Advantage plan. Members may enroll in a Medicare Advantage plan only during specific times of the year. Contact the Medicare plan for more information.
  • If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or your state Medicaid Office.
  • Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next.
  • A Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. Providers who do not contract with the plan are not required to see you except in an emergency.
  • Disclaimer for Institutional Special Needs Plan (SNP): This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care and resides in a nursing home.
  • Disclaimer for Dual Eligible (Medicare/Medicaid) Special Needs Plan (SNP): This plan is available to anyone who has both Medical Assistance from the State and Medicare. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.
  • Disclaimer for Chronic Condition Special Needs Plan (SNP): This plan is available to anyone with Medicare who has been diagnosed with the plan specific Chronic Condition.
  • Medicare MSA Plans combine a high deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). The plan deposits money from Medicare into the account. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins.
  • Medicare MSA Plans do not cover prescription drugs. If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D prescription drug plan
  • There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. Those who disenroll during the calendar year will owe a portion of the account deposit back to the plan. Contact the plan provider for additional information.
  • Medicare beneficiaries may enroll through the CMS Medicare Online Enrollment Center located at www.medicare.gov.
  • Medicare beneficiaries can file a complaint with the Centers for Medicare & Medicaid Services by calling 1-800-MEDICARE 24 hours a day/7 days or using the medicare.gov site. Beneficiaries can appoint a representative by submitting CMS Form-1696.
.