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Prescription Drug Coverage (Part D)

WellCare Medicare Part D Prescription Drug Plans help to cover the cost of prescription drugs. Many of our plans offer low monthly premiums and $0 or low co-pays on the medications you take to feel and be your independent best.

Part D Coverage Stages

Medicare Part D prescription drug coverage includes four cost-sharing stages. The amount you pay to fill your prescription drugs depends on the payment stage you are in.

1

Stage 1: Deductible

The amount you pay before a plan covers your prescription drugs costs, if applicable. Some WellCare plans have no deductible.

2

Stage 2: Initial Coverage

During this stage, the plan pays its share of the cost and you pay your share. You are in this stage until your payments and the plan’s payments total $4,130 for the year.

3

Stage 3: Coverage Gap

When your drug costs and plan payments for the year reach $4,130, you enter the Coverage Gap Stage, commonly known as the "Donut Hole". In this stage, you will pay 25% of the cost for covered generic and brand-name drugs until your out-of-pocket costs for the year reach $6,550.

4

Stage 4: Catastrophic Coverage

After your out-of-pocket costs for prescription drugs reach $6,550, the plan will pay most of your drug costs for the rest of the year. You will pay either 5% of the cost of the drug, or a co-pay of $3.70 for generic drugs or $9.20 for all other drugs, whichever is greater.

Part D is one of Medicare's Four Different Parts.

  • Part A – Hospital Insurance

    Part A covers inpatient care, skilled nursing facilities, hospice and some home health care. You will have out-of-pocket costs for your hospital stay, such as deductibles and coinsurance.

  • Part B – Medical Insurance

    Part B helps with the costs of doctor visits, outpatient services and some preventive services. With Part B, there are additional costs you have to pay, such as a monthly premium, annual deductible and coinsurance. Parts A and B together are called Original Medicare.

  • Part C – Medicare Advantage

    Medicare Advantage, also called Part C, provides Part A and Part B coverage in one plan. Medicare Advantage plans may offer extra benefits, such as dental, vision and hearing coverage. Medicare Advantage Plans that include prescription drug coverage are called MAPD plans. These plans give you the option to get your health and prescription drug benefits from one plan.

  • Part D – Prescription Drug Coverage

    Part D is a stand-alone Medicare Prescription Drug Plan (PDP) that works alongside Original Medicare (Part A and Part B) to help with prescription drug costs.

Learn more about your Medicare Prescription Drug Coverage Options

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