Medicare Prescription Drug Plan Benefit Details in Plain Text|
|The following Medicare Prescription Drug plan (PDP) benefits apply to the EnvisionRxPlus Silver (PDP) plan (S7694 - 014) in CMS Region 14, which includes all counties in OH.|
This plan is administered by ENVISION INSURANCE COMPANY, a national plan provider. This means that the insurance carrier offers Medicare Part D plan in most every state. To switch to a different Medicare Prescription Drug plan or to change your location, click here.
Click here to see this information for the EnvisionRxPlus Silver (PDP) plan in a chart format along with the plan enrollment options. We will also send a copy of the plan benefit details chart to your email account.|
|The EnvisionRxPlus Silver (PDP) plan has a monthly premium of $32.00. That is $384.00 for 12 months. There are a few factors that can increase or decrease this premium. If you qualify for full or partial extra help, your premium will be lower. If you have a premium penalty, your premium will be higher.|
|Plan Membership and Plan Ratings|
|The EnvisionRxPlus Silver (PDP) plan a new plan in county, therefore we do not yet have membership figures. The Centers for Medicare and Medicaid Services (CMS) has rated ENVISION INSURANCE COMPANY as follows: a Customer Service Rating of 3 out of 5 stars a Member Experience Rating of 3 out of 5 stars a Drug Cost Information Accuracy Rating of 3 out of 5 stars. |
|Prescription Drug Coverage: Deductible, Cost-sharing, Formulary|
|This plan has a $310.00 deductible. That means that you are 100% responsible for the first $310.00 in medication costs and after that is met, the EnvisionRxPlus Silver (PDP) plan will share the costs of your medications with you. (See cost-sharing below). $310.00 is the maximum deductible for 2011. There are other plans with a lower deductible or even a $0 deductible. Click here to review plans with a $0 deductible.|
|The following information is about the EnvisionRxPlus Silver (PDP) formulary (or drug list). There are 2388 drugs on the EnvisionRxPlus Silver (PDP) formulary. |
|The Initial Coverage Phase (ICP) can be thought of as the cost-sharing phase of the plan. During this phase, you and the insurance company share your prescription costs. Once you have spent $310.00, your initial coverage phase will start. All medication are divided into tiers within the plans formulary. This helps the plan to organize and manage the prescription cost-sharing. The EnvisionRxPlus Silver (PDP) plan’s formulary is divided into 5 tiers. Every plan can name their tiers differently, and can place medications on any tier. The cost-sharing for this plan is divided as follows: Tier 1 contains Tier 1 Preferred Generics drugs. The tier 1 co-insurance is 25% of the drug costs. Tier 2 contains Tier 2 Non-Preferred Generics drugs. The tier 2 co-insurance is 25% of the drug costs. Tier 3 contains Tier 3 Preferred Brand drugs. The tier 3 co-insurance is 25% of the drug costs. Tier 4 contains Tier 3 Preferred Brand drugs. The tier 4 co-insurance is 25% of the drug costs. Tier 5 contains Tier 5 Specialty Drugs drugs. The tier 5 co-insurance is 25% of the drug costs. The EnvisionRxPlus Silver (PDP) plan’s Initial Coverage Limit is $2840. When this limit is reached, you exit the Initial Coverage Phase and enter the Coverage Gap (or Donut Hole).|
|The Coverage Gap, which is also known as the Donut (Doughnut) Hole is the phase of your Medicare Part D plan where
you are responsible for 100% of your medication costs. Healthcare Reform mandates that the insurance carrier pay 7% of your generic drug prescription costs in the donut hole on your behalf.
The brand-name drug pharmceutical company will pay 50% of the cost of your brand-name drugs pruchased in the donut hole on your behalf. Since these two groups are paying on
your behalf, the portion that they pay counts toward your TrOOP (or True Out of Pocket) costs. Some Medicare Part D plans offer coverage during the Coverage Gap that is beyond the mandated discounts.
Any drug not covered by the plan’s Gap Coverage will still receive the discounts noted above -- even if the plan has "No Gap Coverage". This plan (EnvisionRxPlus Silver (PDP)) offers No Coverage during the Coverage Gap phase.|