Classic and Value Plus plans:

No deductible.

Your co-pays for the first $2,930 of your annual prescription drug costs (your cost plus UCare's cost) are as follows:

• Up to an $10 co-pay per generic drug up to a 30-day supply.
• $35 co-pay per preferred brand-name drug up to a 30-day supply.
• $70 co-pay per other brand-name drug up to a 30-day supply.
• 25% co-insurance per specialty drug.
• Two co-pays for a 90-day supply of maintenance drugs through our mail order program and at network retail pharmacies that offer a 90-day supply.

Standard D plan:

You must pay a $320 annual deductible on covered Part D drugs before coverage begins.

There is a 25% co-insurance until you have reached $2,930 in annual prescription drug costs (your cost plus UCare's cost).

Classic plan:

Once you have reached $2,930 in annual prescription drug costs, you continue to have coverage for generic drugs throughout the coverage gap with the following co-pay or co-insurance:

• Up to an $10 co-pay per Tier 1 generic drug up to a 30-day supply.
• 86% of the cost of any Tier 4 generic drug.
• Two co-pays for a 90-day supply of Tier 1 generic maintenance drugs through our mail order program and at network retail pharmacies that offer a 90-day supply.

Value Plus and Standard D plans:

For generic drugs, you will pay 86% of the cost of the drug.

Classic, Value Plus, and Standard D plans:

You will receive a 50% discount on brand-name drugs from manufacturers that have agreed with the Federal government to pay the discount (if not already receiving "Extra Help"). We will automatically apply the discount when your pharmacy bills you for your prescription and you will receive an Explanation of Benefits that will show any discount provided. The amount discounted by the manufacturer counts toward your out-of-pocket costs as if you had paid this amount and moves you through the coverage gap. You continue to pay until your "out-of-pocket" costs reach $4,700.