2018 Farm Bureau Select Rx (PDP) S2668-6-0 in AL from Members Health Insurance Company | HealthPocket

Farm Bureau Select Rx (PDP)

Prescription Drug Plan for Alabama

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PARTD

Plan Summary

Insurance TypeMedicare Advantage Prescription Drug Plan (Part D)
Insurance ProviderMembers Health Insurance Company
Plan IDS2668-6-0
CMS RatingNot Rated1
Plan TypePDP
Annual Deductible$0.00

What To Know About This Plan

  • This is a drug coverage only plan

Plan Details

Costs and Other Important Information

Plan Year:
2018
Optional Supplemental Benefits
No
Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)
Not Applicable
Other health plan deductibles?
Yes
Health Plan Deductible
Coming soon
Monthly Drug Plan Premium
$74.40
Monthly Health Plan Premium
Not Applicable

Benefits

Service
Cost
Inpatient hospital coverage
Coming soon
Outpatient hospital coverage
20% per visit
Doctor visits
Primary:
20% per visit
Specialist:
20% per visit
Preventive care
20%
Emergency care/Urgent care
Emergency:
20%
Urgent care:
20%
Diagnostic procedures/lab services/imaging
Diagnostic tests and procedures:
20%
Lab services:
20%
Diagnostic radiology services (e.g., MRI):
20%
Outpatient x-rays:
20%
Mental health services
Coming soon
Outpatient group therapy visit with a psychiatrist:
20%
Outpatient individual therapy visit with a psychiatrist:
20%
Outpatient group therapy visit:
20%
Outpatient individual therapy visit:
20%
Skilled Nursing Facility
Coming soon
Rehabilitation services
Occupational therapy visit:
20%
Physical therapy and speech and language therapy visit:
20%
Ambulance
20%
Transportation
No
Foot care (podiatry services)
Foot exams and treatment:
20%
Routine foot care:
20%
Medical equipment/supplies
Durable medical equipment (e.g., wheelchairs, oxygen):
20% per item
Prosthetics (e.g., braces, artificial limbs):
20% per item
Diabetes supplies:
20% per item
Wellness programs (e.g., fitness, nursing hotline)
No
Medicare Part B drugs
Chemotherapy:
20%
Other Part B drugs:
20%

Coverage Area for Farm Bureau Select Rx (PDP)

StateAlabama
CountyJefferson

Cost Sharing Information

All cost-sharing assumes in-network healthcare providers.

Prescription Drug Copay/Coninsurance Details - Initial Coverage Limit

30 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred GenericNot offereds$1 copayNot offered
Tier 2: Non-Preferred GenericNot offered$4 copayNot offered
Tier 3: Preferred Brand NameNot offered$35 copayNot offered
Tier 4: Non-Preferred Brand NameNot offered35% coinsuranceNot offered
Tier 5: Specialty TierNot offered33% coinsuranceNot offered
90 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred GenericNot offered$3 copayNot offered
Tier 2: Non-Preferred GenericNot offered$12 copayNot offered
Tier 3: Preferred Brand NameNot offered$105 copayNot offered
Tier 4: Non-Preferred Brand NameNot offered35% coinsuranceNot offered
Tier 5: Specialty TierNot offered33% coinsuranceNot offered

CMS Ratings

Drug Plan Customer Service

Call center – foreign language interpreter and TTY/TDD availability - Drugs
Not Rated
Appeals auto-forward
Not Rated
Appeals upheld

Member Complaints, and Changes in Drug Plan's Performance

Complaints about the drug plan
Not Rated
Members choosing to leave the drug plan
Not Rated
Beneficiary access and performance problems
Not Rated
Drug plan quality improvement
Not Rated

Member Experience with Drug Plan

Rating of drug plan
Not Rated
Getting needed prescription drugs
Not Rated

Drug Pricing and Patient Safety

MPF Price Accuracy
Not Rated
High risk medication
Not Rated
Part D medication adherence for diabetes
Not Rated
Part D medication adherence for hypertension
Not Rated
Part D medication adherence for cholesterol
Not Rated
Medication Therapy Management program completion rate
Not Rated

Pharmacy Finder

Pharmacies that accept Farm Bureau Select Rx (PDP) Prescription Drug Plan for Alabama

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