2021 WellCare Medicare Rx Value Plus (PDP) S5768-129-000 in PA from WellCare | HealthPocket

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County

Insurance Type	Medicare Advantage Prescription Drug Plan (Part D)
Insurance Provider	WellCare
Plan ID	S5768-129-000
Plan Year	2021
CMS Rating
Plan Type	PDP
Annual Deductible	$0.00
Out-of-Pocket Maximum	N/A

What To Know About This Plan	This is a drug coverage only plan

Why We Like This Plan	has a copay of $1 for Tier 1 preferred generic drugs (30 day supply, preferred retail pharmacies)

Costs and Other Important Information

Plan Year	2021
Prescription Drugs Covered?	Yes
Health Plan Deductible	$0
Monthly Drug Plan Premium	$75.6
Monthly Health Plan Premium	$0

All cost-sharing assumes in-network healthcare providers.
Prescription Drug Copay/Coninsurance Details - Initial Coverage Limit

30 Day Supply	Preferred Retail Pharmacies Drug Cost	Standard Retail Pharmacies Drug Cost	Preferred Mail-Order Drug Cost	Standard Mail-Order Drug Cost
Tier 1: Preferred Generic	$1 copay	$10 copay	$1 copay	$10 copay
Tier 2: Generic	$4 copay	$20 copay	$4 copay	$20 copay
Tier 3: Preferred Brand	$47 copay	$47 copay	$47 copay	$47 copay
Tier 4: Non-Preferred Drug	50% coinsurance	50% coinsurance	50% coinsurance	50% coinsurance
Tier 5: Specialty Tier	33% coinsurance	33% coinsurance	33% coinsurance	33% coinsurance

90 Day Supply	Preferred Retail Pharmacies Drug Cost	Standard Retail Pharmacies Drug Cost	Preferred Mail-Order Drug Cost	Standard Mail-Order Drug Cost
Tier 1: Preferred Generic	$3 copay	$30 copay	$0 copay	$30 copay
Tier 2: Generic	$12 copay	$60 copay	$10 copay	$60 copay
Tier 3: Preferred Brand	$141 copay	$141 copay	$117.5 copay	$141 copay
Tier 4: Non-Preferred Drug	50% coinsurance	50% coinsurance	50% coinsurance	50% coinsurance
Tier 5: Specialty Tier

Drug Plan Customer Service

Call center – foreign language interpreter and TTY availability
Appeals auto-forward
Appeals upheld

Member Complaints, and Changes in Drug Plan's Performance

Complaints about the drug plan
Members choosing to leave the drug plan
Drug plan quality improvement

Member Experience with Drug Plan

Rating of drug plan
Getting needed prescription drugs

Drug Pricing and Patient Safety

MPF Price Accuracy
Medication adherence for diabetes medications
Medication adherence for hypertension - RAS antagonists
Medication adherence for cholesterol - Statins
MTM program completion rate for CMR
Statin use in persons with diabetes - SUPD

Pharmacies that accept WellCare Medicare Rx Value Plus (PDP) Prescription Drug Plan for Pennsylvania

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UPMC for Life HMO Premier Rx (HMO)
COST:from $0	CMS Rating:

Personal Choice 65 Prime Rx (PPO)
COST:from $0	CMS Rating:

Community Blue Medicare PPO Signature (PPO)
COST:from $0	CMS Rating:

BlueJourney Select (PPO)
COST:from $0	CMS Rating:

Geisinger Gold Preferred Complete Rx (PPO)
COST:from $0	CMS Rating:

HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, or an individual and family health insurance plan, we will help you find the right healthcare option and save on your out of pocket healthcare costs. We receive our data from government, non-profit and private sources, and you should confirm key provisions of your coverage with your selected health plan. If you select a plan presented on our site, you will be directed (via a click or a call) to one of our partners who can help you with your application. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan. HealthPocket, Inc. is part of the Benefytt Technologies, Inc. family of companies.

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HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, or an individual and family health insurance plan, we will help you find the right healthcare option and save on your out of pocket healthcare costs. We receive our data from government, non-profit and private sources, and you should confirm key provisions of your coverage with your selected health plan. If you select a plan presented on our site, you will be directed (via a click or a call) to one of our partners who can help you with your application. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan. HealthPocket, Inc. is part of the Benefytt Technologies, Inc. family of companies.