2015 Regence Medicare Prescription Drug Plans (PDP)
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1 VIEW PLA OVER DECISION GUIDE 2015 Regence Medicare Prescription Drug Plans (PDP) Regence BlueShield of Idaho and Regence BlueCross BlueShield of Utah is an Independent Licensee of the Blue Cross and Blue Shield Association S5916_08390 Approved ID and UT 2015 PDP
2 GET STARTED READ. In this booklet you will find the tools you need to make an informed decision about choosing a Regence Medicare Prescription Drug Plan. It provides important information so you can weigh your options and find the plan that best fits your needs. You can compare benefits, learn more about our plans, and view instructions on how to enroll. CALL. If you would like help along the way, just call one of our Plan s Medicare sales representatives at REGENCE ( ) 8 a.m to 5 p.m., Monday through Friday. TTY users should call 711. GO ONLINE. A wealth of information is available at your fingertips at regence.com/medicare. Search for your prescriptions in our formulary (list of covered prescription drugs), locate a pharmacy near you from our pharmacy network, or learn more about our Prescription Drug Plans.
3 CHOOSING A PLAN THAT S RIGHT FOR YOU Regence BlueShield of Idaho and Regence BlueCross BlueShield of Utah offer Medicare Part D prescription drug plan choices to meet your needs and fit your budget. We re here to help you decide which plan is right for you. Regence Medicare Prescription Drug Plans are designed with the benefits you need to be healthy and give you peace of mind. Our plans include a no or low-cost deductible option and feature low copays on many prescriptions. As a Regence Medicare Prescription Drug Plan member, you ll find it easy to access your prescription drug benefits when you use one of the over 63,000 pharmacies in our network. Regence Prescription Drug Plans provide the right coverage for you u Simple, easy-to-understand drug benefit plans. u Formulary that covers all classifications of Medicare-approved prescription drugs. u Access to over 63,000 pharmacies nationwide, including most large chain pharmacies. u Low copays for preferred generic drugs. u Gap coverage for preferred generics on the Regence Medicare Script Enhanced Plan. u Save time and money when you order a three-month supply of your maintenance medication. 1 ID and UT PDP
4 COMPARE BENEFITS With Regence Medicare Prescription Drug Plans, you have coverage for all classifications of Medicare Part D-covered prescription medications. What you pay your deductible, copay or coinsurance depends on which medication you use and which plan you have. On either plan, Tier 1 preferred generics offer the greatest value. If you are like most people who don t expect to reach the Coverage Gap, the Regence Medicare Script Basic plan is a great value. If you are looking for a plan with no deductible, low cost-sharing amounts and coverage for generic drugs in the Coverage Gap, then Regence Medicare Script Enhanced is for you! Prescription Drug Coverage Regence Medicare Script ENHANCED Regence Medicare Script BASIC Monthly premium $ $93.80 Annual Rx deductible $0 $155 STAGE 1: Initial Coverage Stage 1-Month supply (in-network retail pharmacy) Tier 1: Preferred generics $5 $10 Tier 2: Non-preferred generics $12 $15 Tier 3: Preferred brands $45 $45 Tier 4: Non-preferred brands $95 $95 Tier 5: Specialty drugs 33% 29% 3-Month supply (in-network retail pharmacy or mail-order pharmacy) Tier 1: Preferred generics $10 $20 Tier 2: Non-preferred generics $24 $30 Tier 3: Preferred brands $ $ Tier 4: Non-preferred brands $ $ Tier 5: Specialty drugs Not applicable; limited to a 30-day supply STAGE 2: Coverage Gap Stage (after prescription costs reach $2,960) Tier 1: Preferred generic drugs $5 You pay 65% All other generic drugs You pay 65% Brand drugs You pay 45% STAGE 3: Catastrophic Coverage Stage (after you have paid $4,700 out-of-pocket) Generic drugs You pay the greater of 5% or $2.65 Brand drugs You pay the greater of 5% or $ ID and UT PDP 2015
5 THE COVERAGE GAP How it works $ STAGE 1: Initial Coverage STAGE 2: Coverage Gap STAGE 3: Catastrophic Coverage You pay a little Plan pays most You pay most You pay a little Plan pays a little Plan pays most After you pay your annual deductible (if applicable), you pay a copay or coinsurance for each prescription you fill. Your plan pays the rest until the total that you and the plan pay reaches $2,960. After your total drug costs reach $2,960, you pay 65% of the cost of generic prescription drugs and 45% of the cost of most brandname prescription drugs until your total out-of-pocket prescription drug costs reach $4,700. Total out-of-pocket costs are the amounts paid by you in the first two stages plus any applicable drug manufacturer discounts applied in the Coverage Gap stage. After your total drug costs reach $4,700, you pay the greater of 5% coinsurance or $2.65 copay for generic drugs, and the greater of 5% coinsurance or $6.60 copay for brand-name drugs. Your plan pays the rest of the cost of your prescription drugs for the rest of the calendar year (through December 31, 2015). Need extra help with prescription drug costs? To determine if you qualify for extra help from Medicare to pay for your prescription drug premiums and costs, call the Social Security Office at between 7 a.m. and 7 p.m., Monday through Friday (TTY users should call ); or your State Medicaid Office. Regence BlueShield of Idaho and Regence BlueCross BlueShield of Utah is a PDP plan with a Medicare contract. Enrollment in Regence BlueShield of Idaho and Regence BlueCross BlueShield of Utah depends on contract renewal. The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan. Limitations, copayments, and restrictions may apply. Anyone who resides in our service area may apply. Individuals must be entitled to Medicare Part A and/or enrolled in Part B to enroll. You must continue to pay your Medicare Part B premium. Benefits, formularies, pharmacy networks, premiums and/or copayments/coinsurance may change on January 1 of each year. ID and UT PDP
6 PLAN HIGHLIGHTS Save money when you fill a three-month supply of your maintenance medication prescriptions. Take advantage of greater savings and convenience for your ongoing prescription needs when you order a three-month supply of your maintenance medications from an in-network retail pharmacy or mail-order pharmacy. Participating mail-order pharmacies can deliver your prescriptions to your home usually within 14 days from the date of your order. If your prescriptions do not arrive within this time frame you can contact Customer Service for help at between 8 a.m. and 8 p.m., Monday through Friday. TTY users should call 711. We have you covered at home and across the country. Our pharmacy network consists of more than 63,000 participating pharmacies nationwide. With so many participating pharmacies, including most national chains, there s probably one in your neighborhood! You have prescription drug coverage even if you go to an out-of-network pharmacy, although you may have to pay any excess charges over what your plan allows.* Access your pharmacy benefits with one member ID card and virtually no paperwork. As a Regence Medicare Prescription Drug Plan member, you ll find it easy to access your prescription drug benefits when you use one of the over 63,000 pharmacies in our network. Just show your member ID card, and the pharmacy will take care of the claim for you. There s virtually no paperwork, you just pay any cost-sharing amount. * Part D prescription drug coverage is not available outside the United States and its territories. 4 ID and UT PDP 2015
7 READY TO ENROLL? LET S GET STARTED! Before applying: DETERMINE if your pharmacy is in our network. CHECK our formulary for your prescription drugs. Find your pharmacy and view our formulary online at regence.com/medicare. Call us at REGENCE ( ). TTY users should call 711. We re happy to answer any questions or search for your pharmacy and look up your medications for you. DECIDE which Regence Medicare Prescription Drug Plan is right for you. Enrolling is easy: ENROLL BY PHONE. Have one of our Plan s Medicare sales representatives enroll you over the phone by calling REGENCE ( ). TTY users should call 711. ENROLL ONLINE. Enjoy the convenience of applying online. Visit our regence.com/medicare, and follow the instructions to apply. ENROLL BY MAIL. An enrollment application is included in this packet or you can visit regence.com/medicare and download an enrollment application. 1. Complete and sign your application. Verify that the information from your Medicare card is listed correctly on your enrollment application, or make a copy of your Medicare card and attach it to your enrollment application. 2. Use the postage-paid return envelope included in this information packet to mail your completed and signed application. Applications can also be mailed to: P.O. Box 1827, B32M, Medford, OR Please make sure you have sufficient postage. 3. Do not send any payment with your enrollment application. ID and UT PDP
8 Regence Medicare Script Enhanced Regence Medicare Script Basic For more information, call one of our Plan s Medicare sales representatives, 8 a.m. to 5 p.m., Monday through Friday toll-free: REGENCE ( ). TTY users should call 711. Regence BlueShield of Idaho P.O. Box 1106 Lewiston, ID rep06692-ut-id/ Regence BlueShield of Idaho and Regence BlueCross BlueShield of Utah Regence BlueCross BlueShield of Utah P.O. Box Salt Lake City, UT regence.come/medicare
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