Health Alliance Medicare Prescription Plan - Basic Prescription Plan for Illinois Medicare Beneficiaries
| Overall Plan Rating: |  |
|---|---|
| Monthly Premium: | $71.10 |
| 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: | 4871 |
| PDP ID No: | S4219-001 |
| Plan Year: | 2013 |
| Approved by CMS for: | IL Residents |
| Rx Plan Type: | Regional |
| Est. Regional Members: | 2652 |
2018 Medicare Prescription Medication Plan Overview
Health Alliance Medicare Prescription - Basic (PDP) is an approved Medicare Prescription Drug Plan (Part D) for Illinois seniors.
The annual premium is $853.20 ($71.10 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 Alliance Medicare Prescription Plan formulary ID for this plan is 00012145, and it features 4871 FDA approved medications.
For all Illinois 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 Alliance Medicare Prescription Plan - Basic:
- Medco Medicare Prescription Plan - Value at $41.70 per month for Illinois Seniors
- Medco Medicare Prescription Plan - Choice at $99.20 per month for Illinois Seniors
- WellCare Classic at $33.20 per month for Illinois Seniors
Health Alliance Medicare Prescription Plan - Basic 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 Alliance Medicare Prescription - Basic (PDP) plan in Illinois is tiered as follows:
| Tier | Co-Pay Amount | Medications in Tier |
|---|---|---|
| 1 | $0.00 | 1871 Preferred Generics |
| 2 | $30.00 | 134 Non-Preferred Generics |
| 3 | $44.00 | 1630 Preferred Brands |
| 4 | $95.00 | 1067 Non-Preferred Brands |
| 5 | 27% | 169 Specialty Medications |
The Initial Coverage Limit (ICL) is $2,970.00. This prescription plan does not qualify for the $0 LIS premium.
Health Alliance Medicare Prescription - Basic (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 Alliance Medicare Prescription - Basic (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 Alliance Medicare Prescription Plan - Basic policy is 2,652. In region 17 (your region) there are approximately 2,652 people with this policy (based on 2011 CMS statistics).
More Information About Health Alliance Medicare Prescription Plan
Health Alliance Medicare is part of Health Alliance Medical Plans, which has been serving Illinois communities for more than 30 years. We've offered Medicare plans since 1997.
The summary (overall) rating for this Health Alliance Medicare Prescription Plan plan is -1.0 out of 5 based on reviews from 2652 user ratings from the previous year. For more information about the review process, visit http://cms.gov.