Medicare Part D Prescription Drug Coverage
What is Medicare Part D prescription drug coverage?
Members of UCare’s Minnesota Senior Health Options (MSHO) get Medicare Part D prescription drug coverage. This means that Medicare pays for part of their prescription drugs.
How do I know if the drugs I’m taking are covered by UCare?
Click on "Formulary" in the "Important Part D information" section on the right side of your screen. The formulary is a list of drugs that UCare covers. Look for the drugs you’re taking on that list to find out if they are covered.
What will I have to pay for my prescriptions?
The following prescription co-pays are for people who have Medicare, except people who live in a nursing home or other long-term care facility.
| If your income is at or below 100% of federal poverty guidelines: |
- You pay $3.30 for brand name drugs.
- You pay $1.10 for generic drugs.
|
| If your income is between 100% and 135% of federal poverty guidelines: |
- You pay $6.50 for brand name drugs.
- You pay $2.60 for generic drugs.
|
| After your yearly out-of-pocket drug costs reach $4,700, you will have no co-pay. |
Where do I get my prescription drugs?
Generally, you must get your prescription drugs from contracted pharmacies in UCare’s network. To find out if your pharmacy is in UCare’s network, use the Find A Pharmacy Tool.
Do you need extra help paying for prescriptions?
Because you have Medical Assistance, you qualify for and are getting Extra Help to pay for your prescription drug premiums and costs. If you have questions about 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;
- 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.
Your Plan Premium for People who get Extra Help from Medicare to Help Pay for their Prescription Drug Costs
If you get extra help from Medicare to pay for your Medicare prescription drug plan costs, your monthly plan premium will be lower* than what it would be if you did not get extra help from Medicare. The amount of extra help you get will determine your total monthly plan premium as a member of our Plan.
The following table shows you what your monthly plan premium will be if you get extra help. Premiums listed are for both medical services and prescription drug benefits.
| Your level of extra help |
Monthly
premium |
| 100% |
$0 |
| 75% |
$0 |
| 50% |
$0 |
| 25% |
$0 |
*This does not include any Medicare Part B premium you may have to pay.
Questions?
If you are a UCare member, please call UCare Customer Services at 612-676-6868 or 1-866-280-7202 (toll free). If you are hearing impaired, please call our TTY line at 612-676-6810 or 1-800-688-2534 (toll free). Hours of service are 8 a.m. to 8 p.m., daily.
If you're interested in joining UCare’s MSHO, call UCare Sales Representatives at 612-676-3554 or 1-800-707-1711 (toll free). If you are hearing impaired, please call our TTY line at 612-676-6810 or 1-800-688-2534 (toll free). Hours of service are 8 a.m. to 8 p.m., daily.
The benefit information provided herein is a brief summary, not a comprehensive description of benefits. For more information contact the plan. Benefits, formulary, pharmacy network, premium and/or co-payments/co-insurance may change on January 1, 2013. Eligible beneficiaries must use network pharmacies to access their prescription drug benefit, except under non-routine circumstances. Quantity limitations and restrictions may apply. You must use network providers except in emergency or urgent care situations, open access services, out-of-network dialysis services, or any other services previously authorized. If you obtain routine care from out-of-network providers neither Medicare nor UCare will be responsible for the costs.