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Part D Prescription Drug Coverage

MVP’s Medicare Advantage plans offer the convenience of both medical coverage and Part D prescription drug coverage together in one plan, and with one convenient monthly bill.

Note: If you do not join a Medicare Part D plan when you first become eligible for Medicare, or do not have coverage as good as Medicare’s, you may have to pay a penalty if you join at a later date. The penalty can be 1% of the current premium for every month you delay enrollment. This penalty will apply for as long as you are enrolled in Part D coverage.

Programs that may help you save money

Generic drugs at low or no cost!

Check for generic drug and select vaccine pricing on the MVP plan you choose.

Generic drugs have the same active ingredients, strength, and effectiveness as the brand-name versions, but generally at a much lower cost.

What could you save? A lot. Click here to view the list of MVP Preferred Generic Drugs.

MVP’s coverage for medically necessary Medicare Part D approved drugs includes:

Depending on which MVP Medicare Advantage plan you choose, Tier 1 and Tier 6 drugs are available at $0 or no more than $3 through all benefit stages all year long — in the Initial Coverage Stage, the Coverage Gap Stage, and the Catastrophic Coverage Stage.

Note: Drug Tiers do not apply to the BasiCare with Part D PPO plan. With BasiCare you pay 100% of the cost of your drugs until you have met a $320 deductible. Once you’ve spent $320, all drugs in all Tiers are 25%.

Part D drugs excluded from MVP’s Part D Formulary must go through an exception process in order for MVP to cover them. If they are approved, they will be covered in Tier 4.

Coverage in the Gap

If your total drug costs in 2015 reach $2,960, you will pay 65% for generic drugs and 45% for Medicare-contracted brands. When your out-of-pocket drug costs reach $4,700 in 2015, your cost for prescriptions is reduced to the greater of 5% or $2.65 for generics and $6.60 for brand-name drugs. In addition:

For Central New York / Vermont Region
If you choose GoldValue with Part D and are taking a Tier 1 drug, you will pay $3 maximum all year (in the initial coverage phase, the coverage gap, and the catastrophic phase). If you choose Gold PPO with Part D and you are taking a Tier 1 or Tier 6 drug, it will be $0 all year.

Capital District / Southern Tier Region
If you choose GoldValue with Part D and are taking a Tier 1 drug, you will pay $3 maximum all year (in the initial coverage phase, the coverage gap, and the catastrophic phase). If you choose Preferred Gold with Part D or Gold PPO with Part D and you are taking a Tier 1 or Tier 6 drug, it will be $0 all year.

Rochester / Buffalo Region
If you choose GoldValue with Part D or Gold PPO with Part D and are taking a Tier 1 or Tier 6 drug, it will be $0 all year (in the initial coverage phase, the coverage gap, and the catastrophic phase).

Mid-Hudson Region
If you choose GoldValue with Part D and are taking a Tier 1 drug, you will pay $3 maximum all year (in the initial coverage phase, the coverage gap, and the catastrophic phase). If you choose Preferred Gold with Part D and you are taking a Tier 1 or Tier 6 drug, it will be $0 all year.

See more details about MVP’s Medicare Part D Prescription Drug Coverage

Medicare Advantage Part D Covered Drugs and Pharmacy Directory

Click here to view MVP’s 2015 Medicare Part D formulary (list of covered drugs) or find out how your drug is covered under BasiCare with Part D or under GoldValue with Part D, Preferred Gold with Part D or Gold PPO with Part D. To learn more about our pharmacy programs visit our main site at www.mvphealthcare.com/medicare. Click here to view MVP’s 2015 Medicare Advantage Pharmacy Directory or find a pharmacy near you.

NOTE: If you qualify for extra help with your Medicare prescription drug coverage costs, Medicare will pay part of your monthly plan premium. We will bill you for the amount that Medicare does not cover.

Call 1-888-280-6205 TTY: 1-800-662-1220

Experienced MVP Medicare Products Advisors are available Monday – Friday, 8 am to 5 pm Eastern Time.

Or call the MVP Medicare Customer Care Center Monday – Friday, 8 am – 8 pm at 1-800-665-7924.
From October 1 – February 14, call us every day from 8 am to 8 pm.