Educators Rx Basic Prescription Plan for Idaho Medicare Beneficiaries
Overall Plan Rating: | |
---|---|
Monthly Premium: | $78.10 |
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: | 3178 |
PDP ID No: | S5877-004 |
Plan Year: | 2013 |
Approved by CMS for: | ID Residents |
Rx Plan Type: | Regional |
Est. Regional Members: | 362 |
2018 Medicare Prescription Medication Plan Overview
Educators Rx Basic (PDP) is an approved Medicare Prescription Drug Plan (Part D) for Idaho seniors.
The annual premium is $937.20 ($78.10 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 EMI Health formulary ID for this plan is 00012219, and it features 3178 FDA approved medications.
For all Idaho 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 Educators Rx Basic:
- Medco Medicare Prescription Plan - Value at $44.20 per month for Idaho Seniors
- WellCare Classic at $45.20 per month for Idaho Seniors
- Regence Medicare Script Basic at $80.50 per month for Idaho Seniors
Educators Rx 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 Educators Rx Basic (PDP) plan in Idaho is tiered as follows:
Tier | Co-Pay Amount | Medications in Tier |
---|---|---|
1 | $3.00 | 1804 Preferred Generics |
2 | $43.00 | 1016 Non-Preferred Generics |
3 | $63.00 | 162 Preferred Brands |
4 | $85.00 | 196 Non-Preferred Brands |
5 | 0 Specialty Medications | |
The Initial Coverage Limit (ICL) is $2,970.00. This prescription plan does not qualify for the $0 LIS premium.
Educators Rx 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 Educators Rx 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 Educators Rx Basic policy is 362. In region 31 (your region) there are approximately 362 people with this policy (based on 2011 CMS statistics).
More Information About EMI Health
EMI Health is a nonprofit organization, which was founded June 26, 1935. Since that day, EMI Health has continued to evolve into the highly successful health insurance organization that it is today. EMI Health was originally formed as a teachers' welfare organization and has since evolved into a mutually-owned, nonprofit company.
The summary (overall) rating for this EMI Health plan is 3.5 out of 5 based on reviews from 362 user ratings from the previous year. For more information about the review process, visit http://cms.gov.