Health First Essential Prescription Drug Plan Prescription Plan for Florida Medicare Beneficiaries
| Overall Plan Rating: |  |
|---|---|
| Monthly Premium: | $33.60 |
| Pharmacy Co-Pay: | $325.00 |
| Coverage Limit (ICL): | $2,970.00 |
| Pharmacy Mail Order: | Yes |
| Gap Coverage: | No Gap Coverage |
| Low Income Subsidy: | No |
| Medicare Formulary: | 2344 |
| PDP ID No: | S0223-001 |
| Plan Year: | 2013 |
| Approved by CMS for: | FL Residents |
| Rx Plan Type: | Regional |
| Est. Regional Members: | 198 |
2018 Medicare Prescription Medication Plan Overview
Health First Essential Prescription Drug (PDP) is an approved Medicare Prescription Drug Plan (Part D) for Florida seniors.
The annual premium is $403.20 ($33.60 monthly), and it carries a $325.00 deductible on all prescribed medications. For 2013, the maximum Part D deductible is $325. It goes up a little each year. It went up $5 from last year.
The Health First Medicare Plans formulary ID for this plan is 00012186, and it features 2344 FDA approved medications.
For all Florida seniors with Medicare benefits, there are two conditions that can change the amount you pay for your plan. The first is quailfying for the Extra Help program, which lowers your premium. The second is the opposite: if a premium penalty has been imposed on you for not enrolling right away at age 65 open enrollment, then your premium will be marginally higher.
Below are a few plans that are comparable to Health First Essential Prescription Drug Plan:
- Medco Medicare Prescription Plan - Value at $54.20 per month for Florida Seniors
- Medco Medicare Prescription Plan - Choice at $81.30 per month for Florida Seniors
- WellCare Classic at $28.50 per month for Florida Seniors
Health First Essential Prescription Drug Plan Initial Coverage
In the ICP (Initial Coverage Phase) the cost of your prescriptions is shared with your insurance company. You and the carrier each pay your share (as determined by the plan) until you reach the Initial Coverage Limit (ICL). In 2013, the ICL is $2,970 and this number changes each year. This plan has a deductible that you must pay before ICP cost-sharing ICP begins.
Each prescription medication is put into a tier within each Medicare Part D plan's drug formulary. Different tiers have different levels of cost-sharing. It's important to note that these tiers are not completely standardiszed and your prescriptions may be found in different tiers on differnt plans. This is why we provide access to all Part D plans' drug formularies, so you can compare what the cost is for your prescription drugs for different Part D plasn in your area.
The pharmacy co-pay with the Health First Essential Prescription Drug (PDP) plan in Florida is tiered as follows:
| Tier | Co-Pay Amount | Medications in Tier |
|---|---|---|
| 1 | $2.00 | 197 Preferred Generics |
| 2 | $10.00 | 1181 Non-Preferred Generics |
| 3 | $42.50 | 691 Preferred Brands |
| 4 | $95.00 | 148 Non-Preferred Brands |
| 5 | 25% | 127 Specialty Medications |
The Initial Coverage Limit (ICL) is $2,970.00. This prescription plan does not qualify for the $0 LIS premium.
Health First Essential Prescription Drug (PDP) 2013 Coverage Gap
The Coverage Gap (aka, "Donut Hole") is the coverage phase where you must pay all of your medication costs. Some plans provide donut hole coverage, and if you think that your drug costs will be high enough to get to this level, you should consider a plan with donut hole coverage. You can learn more about costs in the donut hole by reading What is the Medicare Part D Donut Hole? How long it will take you to reach the donut hole with the Health First Essential Prescription Drug (PDP) plan depends on your specific prescriptions.
The Gap Coverage with this policy: You must pay the $3727.50.
Plan Members
Nationwide, the number of seniors using the Health First Essential Prescription Drug Plan policy is 198. In region 11 (your region) there are approximately 198 people with this policy (based on 2011 CMS statistics).
More Information About Health First Medicare Plans
The Health First family first began in 1995, when three not-for-profit hospitals—Cape Canaveral Hospital in Cocoa Beach, Holmes Regional Medical Center in Melbourne, and Palm Bay Hospital in Palm Bay—united to form a seamless system devoted to integrating quality healthcare services with state-of-the-art technology for the betterment of our community.
Two new divisions, Health First Health Plans and Health First Physicians, were created in 1996 to complete the spectrum of healthcare services for Florida’s Space Coast.
Since then, the Health First family has grown to include outpatient centers; the county’s only trauma center; home care; specialized programs for cancer, heart, stroke, and aging; and also rehabilitative services. The newest campus, Viera Health Park is home to our fourth Pro-Health & Fitness Center, and Viera Hospital which opened in April 2011.
The summary (overall) rating for this Health First Medicare Plans plan is -2.0 out of 5 based on reviews from 198 user ratings from the previous year. For more information about the review process, visit http://cms.gov.