Our Care Basic and Care Today Plans are designed to minimize your out-of-pocket expenses. Our plans offer Part D prescription drug coverage and health benefits that coordinate wth Medicare. The table below offers a side-by-side comparison, so you can choose which combination of medical and prescription drug coverage works best with your budget.
Effective July 1, 2012
Benefits |
Care Basic Plan1 |
Care Today Plan1 |
| Monthly Rates |
$118.00 |
Rates vary accoding to age and Zip Code |
| Coverage |
Part A, Presciption Drugs |
Part A, Part B, Presciption Drugs |
| Initial Prescription Coverage |
Member pays copays for covered drugs (brand-name and generic). Plan pays balance of drug costs. The total of these costs adds up toward the "Coverage Gap." Total drug spend of $2,930. |
Member pays copays for covered drugs (brand-name and generic). Plan pays balance of drug costs. The total of these costs adds up toward the "Coverage Gap." Total drug spend of $2,930. |
| Prescription Coverage Gap |
Member pays lesser of copay or 86% of drug cost for generic drugs. Member pays 100% of discounted drug cost for preferred and non-preferred drugs (brand-name). Member out-of-pocket costs add up toward the "Catastrophic Coverage Zone".2 Total member out-of-pocket costs reaches $4,700 (annual). |
Member pays lesser of copay or 86% of drug cost for generic drugs. Member pays 100% of discounted drug cost for preferred and non-preferred drugs (brand name). Member out-of-pocket costs add up toward the "Catastrophic Coverage Zone".2 Total member out-of-pocket costs reaches $4,700 (annual). |
| Catastrophic Prescription Coverage Zone |
Member pays the greater of 5% of drug cost or $2.60 generic / $6.50 for brand-name. Plan pays the balance of plan cost for the duration of plan year. |
Member pays the greater of 5% of drug cost or $2.60 generic / $6.50 for brand name. Plan pays the balance of plan cost for the duration of plan year. |
| Potential Plan Advantages |
Lower monthly rates |
Broader coverage; can help reduce out-of-pocket expenses |
| Potential Plan Disadvantages |
Does not cover Part B services; can lead to higher out-of-pocket costs |
Higher monthly rates |
1 The Care Basic Plan and Care Today Plan pay health care costs based on Medicare-approved amounts. The participant pays all of the costs for services not covered by Medicare and costs above the Medicare-approved amount.
2 Members will actually pay 50% of brand drug cost after a discount from the pharmaceutical manufacturer. The discounted amount will be charged at the pharmacy. The full retail cost of the drugs will still apply to moving out of the coverage gap ("donut hole") even though 50% was paid for by the pharmaceutical manufacturers.