Wellcare Value Script (PDP)
Health Insurance Company: Wellcare
Medicare Prescription Drug Part D Plan Details
- Rx
- Low Income
Subsidy
General Plan Details
Rx Drug Coverage - Preferred Retail Cost
Tier 1: Preferred Generic
$0.00 copay (30-day supply)
$0.00 copay (90-day supply)
Tier 2: Generic
$5.00 copay (30-day supply)
$15.00 copay (90-day supply)
Tier 3: Preferred Brand
25% coinsurance (30-day supply)
25% coinsurance (90-day supply)
Tier 4: Non-Preferred Drug
41% coinsurance (30-day supply)
41% coinsurance (90-day supply)
Tier 5: Specialty Tier
25% coinsurance (30-day supply)
Rx Drug Coverage - Standard Retail Cost
Tier 1: Preferred Generic
$10.00 copay (30-day supply)
$30.00 copay (90-day supply)
Tier 2: Generic
$15.00 copay (30-day supply)
$45.00 copay (90-day supply)
Tier 3: Preferred Brand
25% coinsurance (30-day supply)
25% coinsurance (90-day supply)
Tier 4: Non-Preferred Drug
42% coinsurance (30-day supply)
42% coinsurance (90-day supply)
Tier 5: Specialty Tier
25% coinsurance (30-day supply)
Rx Drug Coverage - Standard Mail Order Cost
Tier 1: Preferred Generic
$10.00 copay (30-day supply)
$30.00 copay (90-day supply)
Tier 2: Generic
$15.00 copay (30-day supply)
$45.00 copay (90-day supply)
Tier 3: Preferred Brand
25% coinsurance (30-day supply)
25% coinsurance (90-day supply)
Tier 4: Non-Preferred Drug
42% coinsurance (30-day supply)
42% coinsurance (90-day supply)
Tier 5: Specialty Tier
25% coinsurance (30-day supply)
Rx Drug Coverage - Preferred Mail Order Cost
Tier 1: Preferred Generic
$0.00 copay (30-day supply)
$0.00 copay (90-day supply)
Tier 2: Generic
$5.00 copay (30-day supply)
$15.00 copay (90-day supply)
Tier 3: Preferred Brand
25% coinsurance (30-day supply)
25% coinsurance (90-day supply)
Tier 4: Non-Preferred Drug
41% coinsurance (30-day supply)
41% coinsurance (90-day supply)
Tier 5: Specialty Tier
25% coinsurance (30-day supply)
Plan Links
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