Pharmacy
All McLaren Medicare plans have Part D Prescription Drug coverage built into the plan. Your prescription coverage is included in your premium.
Your costs for a covered drug depend on what coverage phase you are in and what tier your drug is in. Below you will find your plan's coverage information including drug phases, tier copays/coinsurance, and insulin costs.
Part D Prescription Drug Coverage Phases
Deductible Phase:
McLaren Medicare plans do not have a Part D deductible. That means you will have prescription drug coverage starting with the first prescription you fill.
Initial Coverage Phase:
You begin this phase when you fill your first prescription of the year and pay set copays or cost shares for covered drugs. Once you reach $2,000, you enter the Catastrophic Coverage Phase.
Catastrophic Coverage Phase:
Once you have moved into the Catastrophic Coverage Phase, you will pay $0 for coverage drugs for the remainder of the year.
Part D Prescription Drug Coverage Tiers
|
|
Tier 1
(Preferred Generic)
|
Tier 2
(Generic)
|
Tier 3
(Preferred Brand)
|
Tier 4
(Non-Preferred Brand)
|
Tier 5
(Specialty Drugs)
|
Tier 6
(Select Care Drugs)
|
|
Standard Retail Pharmacy
(up to a 30-day supply)
|
$0 copay
|
$12 copay
|
$47 copay
|
$100 copay
|
33% coinsurance
|
$0 copay
|
|
Standard Retail Pharmacy
(90-day supply)
|
$0 copay
|
$36 copay
|
$141 copay
|
$300 copay
|
not available
|
$0 copay
|
|
Mail-order Pharmacy
(30-day supply)
|
not available
|
not available
|
not available
|
not available
|
33% coinsurance
|
not available
|
|
Mail-order Pharmacy
(90-day supply)
|
$0 copay
|
$27 copay
|
$105.75 copay
|
$225 copay
|
not available
|
$0 copay
|
Part D Insulin Costs
You won’t pay more than $35 for a one-month supply of each insulin product covered under your Part D Prescription Drug benefit, no matter what cost-sharing tier it is on.
|
|
30-Day Supply
|
90-Day Supply
(standard retail)
|
90-Day Supply
(mail-order)
|
|
Tiers 1 and 6
|
$0
|
$0
|
$0
|
|
Tier 2
|
$10
|
$30
|
$23
|
|
Tiers 3,4 and 5
|
$35
|
$105
|
$79
|
Other Pharmacy pages:
Drug Price Search
Formulary
Medication Therapy Management
Pharmacy Directory
Pharmacy Utilization Management
Transition Policy