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
- Check anytime to see if you are eligible for help from a State Pharmacy Assistance Program. In New York State, call EPIC (Elderly Pharmaceutical Insurance Coverage) program at 1-800-332-3742. In Vermont, call the Vermont Prescription Assistance program at 1-800-250-8427.
- Check anytime to see if you are eligible to receive Extra Help with prescriptions (called Low Income Subsidy). Call the Social Security Administration Office at 1-800-772-1213. TTY: 1-800-325-0778. In New York you can also call the New York State Health Insurance Information, Counseling and Assistance Program at 1-800-333-4114. In Vermont, call the Area Agency on Aging of Vermont at 1-800-552-3402.
Consider, choose, save!
When you choose an MVP Medicare Advantage plan with Part D, many commonly used Part D prescription drugs and vaccines are available to you for free. You pay nothing — $0 — for select generic drugs used to control blood pressure, to treat diabetes, heartburn and ulcers, and for bone health (osteoporosis). This also includes the most common Part D vaccines: the shingles vaccine (such as Zostavax), tetanus vaccines and combination tetanus/diphtheria/pertussis vaccines (such as Adacel, Boostrix and Tenivac).
Less really is more — $0 cost drugs save you money. Click here to view MVP’s Tier 5 Select Care Drugs.
NOTE: $0-cost generic drugs do not apply for the BasiCare PPO plan.
MVP’s coverage for medically necessary Medicare Part D approved drugs includes:
- Tier 1 – Preferred Generic Drugs
- Tier 2 – Preferred Brand Name Drugs
- Tier 3 – Non-Preferred Brand Name and Non-Preferred Generic Drugs
- Tier 4 – Specialty Drugs
- Tier 5 – Select Care Drugs – $0 for many generic drugs and select vaccines!
Note: Drug tiers do not apply for the BasiCare PPO plan. With BasiCare, you will pay 100 percent of the cost of your drugs until you have met your $310 deductible. Once you’ve spent $310, all drugs in all tiers are 25 percent.
Part D drugs excluded from our formulary must go through an exception process. If they are approved, they will be covered in tier 3. Because BasiCare members pay 25% for all drugs, Tier Exceptions do not apply.
Coverage in the Gap—GoldValue Preferred Gold with Part D, and GoldAnywhere Option 1 and Option 2 plans – If your total drug costs in 2014 reach $2,850, you will pay 72% for generic drugs and 47.5% for Medicare-contracted brands. When your out-of-pocket drug costs reach $4,550 in 2014, your cost for prescriptions is reduced to the greater of 5% or $2.55 for generics and $6.35 for brand-name drugs. If you are taking a Tier 5 drug, it will be $0 all year (in the initial coverage phase, the coverage gap, and the catastrophic phase).
Coverage in the Gap—Basicare Plan – If your total drug costs in 2014 reach $2,850, you will pay 72% for generic drugs and 47.5% for Medicare-contracted brands. When your out-of-pocket drug costs reach $4,550 in 2014, your cost for prescriptions is reduced to the greater of 5% or $2.55 for generics and $6.35 for brand-name drugs.
Medicare Advantage Part D Covered Drugs and Pharmacy Directory
Click here to view MVP’s Medicare Part D formulary (list of covered drugs). To learn more about our pharmacy programs, search for participating pharmacies and check drug prices, visit our main site at www.mvphealthcare.com/medicare.
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.
Price Your Drugs
Call 1-888-280-6205 TTY: 1-800-662-1220
Licensed 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 and Saturday, 8 am – 4 pm at 1-800-665-7924.
From October 1 – February 14, call us every day from 8 am to 8 pm.