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ᎠᏓᏅᏍᏙᏗ ᎠᎩᏍᏗ ᎤᏴᏍᏗ ᎠᏍᏓᏩᏛᏍᏗ ᏗᎯᏓ

ᎢᎩᏓ
ᎦᎴᏴᏙᏗ

Medicare Part D prescription drug plans are also known as PDPs. Medicare Part D is a government program that offers prescription drug insurance to everyone who is entitled to Medicare Part A and/or enrolled in Medicare Part B.

When you are ready to decide on a plan, take the time to understand how the plans work. That way, you can make an informed decision and choose the plan that's right for you.

ᏧᏓᎴᎿᎢ PDPs ᎤᏚᏓᎵ ᏧᏓᎴᎿᎢ ᏗᎩᏍᏗ ᏧᏴᏍᏗ

The federal government has specific guidelines for the types of medications we must cover as well as a minimum standard of benefits we must follow.

Each plan has a formulary (a list of covered drugs) that meets these requirements as required by law. Keep in mind, not all plans are the same. They may vary in cost or specific drugs covered.

ᎢᏳᏃ ᏂᎯ ᎡᏦᏪᎶᏗ ᎾᎿᎢ ᎾᏍᎩ Medicare ᎤᏓᏡᎬ D ᎠᏍᏓᏩᏛᏍᏗ, ᎰᏩᏊ ᎠᎪᎵᏰᏗ ᎾᏍᎩ ᎠᏍᏓᏩᏛᏍᏗ ᎤᎲᎢ ᏂᏕᎬᏅ ᎢᏗᎬᏁᏗ ᏗᎦᏟᏌᏅᎯ ᎾᎢ ᎪᎯᏳᏙᏓ ᎾᏍᎩ ᎠᏎ ᏚᎾᏠᎯᏍᏔᏅᎩ ᏣᏤᎵ ᎠᏓᏅᏍᏙᏗ ᎠᎩᏍᏗ ᎤᏴᏍᏗ ᏣᏚᏓᎸᏛᎢ ᎤᏚᎸᏛ.

ᎢᏳᏃ ᏂᎯ ᏱᏣᎭ Ꮎ ᏃᏊ ᏥᎩ Medicare ᎠᏜᏅᏓᏗᏍᎬ ᎠᏍᏓᏩᏛᏍᏗ

ᎢᏳᏃ ᏣᏤᎵ Medicare Advantage ᎠᏍᏓᏩᏛᏍᏗ ᏓᏠᏯᏍᏗ ᎠᏓᏅᏍᏙᏗ ᎠᎩᏍᏗ ᎤᏴᏍᏗ ᏣᏚᏓᎸᏛᎢ ᎠᎴ ᏂᎯ ᏣᏖᎳᏗᏍᏗ Medicare PDP, ᏂᎯ ᎠᏎ ᏕᎪᏪᎸ ᏕᏣᏙᎥ ᎪᏣᎴᏍᏗ ᎨᏎᏍᏗ ᎾᏍᎩᎾ ᏣᏤᎵ Medicare Advantage ᎠᏍᏓᏩᏛᏍᏗ ᎠᎴ ᏅᏛᎤᏨᏛ ᎾᎢ ᎢᎬᏱ ᎠᎴᏅᏔᏅ Medicare ᎬᏗ ᏣᏤᎵ Medicare PDP.

Medicare Drug Coverage (Part D) Late Enrollment Penalty

The late enrollment penalty is an amount that’s added to your monthly Medicare drug plan (Part D) premium. You may owe a late enrollment penalty if at any time after your Initial Enrollment Period is over, there’s a period of 63 or more days in a row when you don’t have Medicare drug coverage or other credible prescription drug coverage. You will generally have to pay the penalty for as long as you have Medicare drug coverage.

ᎾᏳᎢ ᏱᏂᎦᎵᏍᏗ ᎾᎢ ᎠᏚᏓᎸᏗᎢ, ᏂᎯ ᏣᎲᎢ ᏗᏑᏰᏍᏗ:

  • ᏂᎯ ᏰᎵᏊ ᎨᏣᎩᏍᏗ ᎠᏓᏅᏍᏙᏗ ᎠᎩᏍᏗ ᎤᏴᏍᏗ ᏣᏚᏓᎸᏛᎢ ᏬᎶᎯᏍᏗ Medicare PDP (ᎤᏓᏡᎬ D).
  • ᏂᎯ ᏰᎵᏊ ᎠᏖᎳᏗᏍᏗ ᎾᏍᎩᎾ Medicare Advantage ᎠᏍᏓᏩᏛᏍᏗ (HMO ᎠᎴᏃ PPO) ᎠᎴᏃ ᏐᎢ Medicare ᏅᏩᏙᎯᏯᏛ ᎠᏍᏓᏩᏛᏍᏗ ᎾᏍᎩᎾ ᏓᏂᏍᎪᎸᏗᏍᎬ Medicare ᎠᏓᏅᏍᏙᏗ ᎠᎩᏍᏗ ᎤᏴᏍᏗ ᏣᏚᏓᎸᏛᎢ.

ᎤᏓ ᎢᎦᎢ ᏗᎵᏏᏅᏙᏗ ᎤᏓ ᎢᎦᎢ ᎠᏚᏓᎸᏗᎢ. ᎤᎾᏓᎦᏎᏍᏙᏗ ᎢᏯᏓᏛᏁᏗ.

  • Wellcare offers plans designed to help those eligible for Extra Help (Low Income Subsidy) where members may pay no or low premiums and copays if enrolled
  • Low premium plans are also available in all states with copays starting as low as $0 when filled at preferred pharmacies
  • Wellcare also offers plans with no deductible which means the plan begins covering prescription drug costs on day one
  • Thousands of network pharmacies are available nationwide in our network including national, regional and local chains, grocers and independent pharmacies
  • We partner with preferred pharmacies to help save member’s money. Preferred pharmacies in our network include many well-known national and regional retailers. Use our
    Find a Provider tool to find a preferred pharmacy closest to you

Member Service representatives are ready to help you with any questions about your coverage or medications. For a complete list of drugs covered by our plan, please review our website or contact our member services department.

ᎤᎵᏍᎨᏓ ᎧᏃᎮᏢᎥᏍᎩ

Disclaimers

‘Ohana Health Plan, a plan offered by WellCare Health Insurance of Arizona, Inc.

Wellcare is the Medicare brand for Centene Corporation, an HMO, PPO, PFFS, PDP plan with a Medicare contract and is an approved Part D Sponsor. Our D-SNP plans have a contract with the state Medicaid program. Enrollment in our plans depends on contract renewal.

“Wellcare” is issued by WellCare Prescription Insurance, Inc.

Washington residents: “Wellcare” is issued by Wellcare of Washington, Inc.

Every year, Medicare evaluates plans based on a 5-star rating system.

Out-of-network/non-contracted providers are under no obligation to treat Plan members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.

Louisiana D-SNP members: As a Wellcare HMO D-SNP member, you have coverage from both Medicare and Medicaid. You receive your Medicare health care and prescription drug coverage through Wellcare and are also eligible to receive additional health care services and coverage through Louisiana Medicaid. Learn more about providers who participate in Louisiana Medicaid by visiting www.myplan.healthy.la.gov/en/find-provider or www.louisianahealthconnect.com. For detailed information about Louisiana Medicaid benefits, please visit the Medicaid website at https://ldh.la.gov/medicaid and select the “Learn about Medicaid Services” link. To request a written copy of our Medicaid Provider Directory, please contact us.

Louisiana D-SNP prospective enrollees: For detailed information about Louisiana Medicaid benefits, please visit the Medicaid website at https://ldh.la.gov/medicaid or www.louisianahealthconnect.com. To request a written copy of our Medicaid Provider Directory, please ᎢᏍᎩᏟᏃᎮᏓ ᏂᎦᏓ.

Notice: TennCare is not responsible for payment for these benefits, except for appropriate cost sharing amounts. TennCare is not responsible for guaranteeing the availability or quality of these benefits. Any benefits above and beyond traditional Medicare benefits are applicable to Wellcare Medicare Advantage only and do not indicate increased Medicaid benefits.

Wellcare (HMO and HMO SNP) includes products that are underwritten by WellCare of Texas, Inc., WellCare National Health Insurance Company, and SelectCare of Texas, Inc.

Wellcare’s pharmacy network includes limited lower-cost, preferred pharmacies in rural areas of Georgia, Hawaii, Missouri, and Nebraska. The lower costs advertised in our plan materials for these pharmacies may not be available at the pharmacy you use. For up-to-date information about our network pharmacies, including whether there are any lower-cost preferred pharmacies in your area, please call 1-866-892-8340 (TTY: 711) for Wellcare No Premium (HMO) in GA or consult the online pharmacy directory at www.wellcare.com/medicare; 1-877-457-7621 (TTY: 711) for Wellcare ‘Ohana No Premium (HMO) and Wellcare ‘Ohana Low Premium Open (PPO) in HI or consult the online pharmacy directory at www.wellcare.com/ohana; 1-833-444-9088 (TTY: 711) for Wellcare No Premium (HMO), Wellcare Giveback (HMO), and Wellcare Assist (HMO) in MO or consult the online pharmacy directory at www.wellcare.com/medicare; and 1-800-977-7522 (TTY: 711) for Wellcare No Premium (HMO), Wellcare Giveback (HMO), Wellcare No Premium Open (PPO), and Wellcare Assist Open (PPO) in NE or consult the online pharmacy directory at www.wellcarene.com.

Value-Added Items and Services (VAIS) are not plan benefits and are not covered by the plan. Plan enrollees are responsible for all costs.

Wellcare Dual Liberty (HMO-D-SNP) Plan

Wellcare Dual Liberty (HMO D-SNP) is a Fully Integrated Dual Eligible Special Needs Plan with a Medicare contract and a contract with the New Jersey Medicaid program. Enrollment in Wellcare Dual Liberty depends on contract renewal.

This information is not a complete description of benefits. Contact the plan for more information. Limitations and restrictions may apply. Benefits may change on January 1 of each year.

Your Part B premium is covered by Medicaid.

This plan is available to those who have both Medicare and full Medicaid benefits.

Wellcare uses a formulary.

Please contact Wellcare for details.

  • ᏗᎦᎾᏄᎪᏫᏍᏗ

    Disclaimers

    ‘Ohana Health Plan, a plan offered by WellCare Health Insurance of Arizona, Inc.

    Wellcare is the Medicare brand for Centene Corporation, an HMO, PPO, PFFS, PDP plan with a Medicare contract and is an approved Part D Sponsor. Our D-SNP plans have a contract with the state Medicaid program. Enrollment in our plans depends on contract renewal.

    “Wellcare” is issued by WellCare Prescription Insurance, Inc.

    Washington residents: “Wellcare” is issued by Wellcare of Washington, Inc.

    Every year, Medicare evaluates plans based on a 5-star rating system.

    Out-of-network/non-contracted providers are under no obligation to treat Plan members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.

    Louisiana D-SNP members: As a Wellcare HMO D-SNP member, you have coverage from both Medicare and Medicaid. You receive your Medicare health care and prescription drug coverage through Wellcare and are also eligible to receive additional health care services and coverage through Louisiana Medicaid. Learn more about providers who participate in Louisiana Medicaid by visiting www.myplan.healthy.la.gov/en/find-provider or www.louisianahealthconnect.com. For detailed information about Louisiana Medicaid benefits, please visit the Medicaid website at https://ldh.la.gov/medicaid and select the “Learn about Medicaid Services” link. To request a written copy of our Medicaid Provider Directory, please contact us.

    Louisiana D-SNP prospective enrollees: For detailed information about Louisiana Medicaid benefits, please visit the Medicaid website at https://ldh.la.gov/medicaid or www.louisianahealthconnect.com. To request a written copy of our Medicaid Provider Directory, please ᎢᏍᎩᏟᏃᎮᏓ ᏂᎦᏓ.

    Notice: TennCare is not responsible for payment for these benefits, except for appropriate cost sharing amounts. TennCare is not responsible for guaranteeing the availability or quality of these benefits. Any benefits above and beyond traditional Medicare benefits are applicable to Wellcare Medicare Advantage only and do not indicate increased Medicaid benefits.

    Wellcare (HMO and HMO SNP) includes products that are underwritten by WellCare of Texas, Inc., WellCare National Health Insurance Company, and SelectCare of Texas, Inc.

    Wellcare’s pharmacy network includes limited lower-cost, preferred pharmacies in rural areas of Georgia, Hawaii, Missouri, and Nebraska. The lower costs advertised in our plan materials for these pharmacies may not be available at the pharmacy you use. For up-to-date information about our network pharmacies, including whether there are any lower-cost preferred pharmacies in your area, please call 1-866-892-8340 (TTY: 711) for Wellcare No Premium (HMO) in GA or consult the online pharmacy directory at www.wellcare.com/medicare; 1-877-457-7621 (TTY: 711) for Wellcare ‘Ohana No Premium (HMO) and Wellcare ‘Ohana Low Premium Open (PPO) in HI or consult the online pharmacy directory at www.wellcare.com/ohana; 1-833-444-9088 (TTY: 711) for Wellcare No Premium (HMO), Wellcare Giveback (HMO), and Wellcare Assist (HMO) in MO or consult the online pharmacy directory at www.wellcare.com/medicare; and 1-800-977-7522 (TTY: 711) for Wellcare No Premium (HMO), Wellcare Giveback (HMO), Wellcare No Premium Open (PPO), and Wellcare Assist Open (PPO) in NE or consult the online pharmacy directory at www.wellcarene.com.

    Value-Added Items and Services (VAIS) are not plan benefits and are not covered by the plan. Plan enrollees are responsible for all costs.

    Wellcare Dual Liberty (HMO-D-SNP) Plan

    Wellcare Dual Liberty (HMO D-SNP) is a Fully Integrated Dual Eligible Special Needs Plan with a Medicare contract and a contract with the New Jersey Medicaid program. Enrollment in Wellcare Dual Liberty depends on contract renewal.

    This information is not a complete description of benefits. Contact the plan for more information. Limitations and restrictions may apply. Benefits may change on January 1 of each year.

    Your Part B premium is covered by Medicaid.

    This plan is available to those who have both Medicare and full Medicaid benefits.

    Wellcare uses a formulary.

    Please contact Wellcare for details.

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Y0020_WCM_134133E_M Last Updated On: 5/8/2024