Plan Details | AARP® Medicare Plans from UnitedHealthcare®
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{{planYear}} Medicare Advantage Plan Details

{{planYear}} Medicare Advantage Plan Details

{{planYear}} Prescription Drug Plan Details

{{planYear}} Special Need Plan Details

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Prescription Drug Benefits

Drug Co-pay & Discounts

Prescription Drugs Your Costs

Annual Prescription Deductible   

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Initial Coverage Stage Preferred Retail Cost Sharing (30 days) Standard Network Pharmacy Cost Sharing (30 days) Preferred Mail Order Pharmacy (90 days)

Tier 1: Preferred Generic Drugs

Tier 2: Generic Drugs

Tier 3: Preferred Brand Drugs

Tier 4: Non-Preferred Brand Drugs

Tier 5: Specialty Tier Drugs

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N/A

${{benefits.icNonPreferredMonthlyCopay | portalCurrency}} co-pay

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N/A

${{benefits.icNonPreferredMonthlyCopay | portalCurrency}} co-pay

{{benefits.icNonPreferredMonthlyCoinsurance}}% of the cost

N/A

${{benefits.icNonPreferredMonthlyCopay | portalCurrency}} co-pay

{{benefits.icNonPreferredMonthlyCoinsurance}}% of the cost

N/A

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${{benefits.icMonthlyCopay | portalCurrency}} co-pay

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N/A

${{benefits.icMailOrderCopay | portalCurrency}} co-pay

{{benefits.icMailOrderCoinsurance}}% of the cost

N/A

Coverage Gap Stage

During the Coverage Gap Stage, you (or others on your behalf) will pay no more than 58% of the total cost for generic drugs or 45% of the total cost for brand name drugs, for any drug tier until the total amount you (or others on your behalf) have paid reaches $4,850 in year-to-date out-of-pocket costs.

You may pay less if your plan has additional coverage in the gap.

Always use your Medicare Advantage member ID card during the coverage gap to get the plan's discounted drug rates. The money you spend using your card counts toward your out-of-pocket costs.

 

During the Coverage Gap Stage, you (or others on your behalf) will pay no more than 58% of the total cost for generic drugs or 45% of the total cost for brand name drugs, for any drug tier until the total amount you (or others on your behalf) have paid reaches $4,850 in year-to-date out-of-pocket costs.

You may pay less if your plan has additional coverage in the gap.

Always use your Medicare Advantage member ID card during the coverage gap to get the plan's discounted drug rates. The money you spend using your card counts toward your out-of-pocket costs.

Catastrophic Coverage Stage

You enter the Catastrophic Coverage Stage after $4,850 is reached (excluding premiums), you will have to pay only one of the following through the end of the year: $2.95 co-pay for generic drugs, $7.40 co-pay for brand name drugs or a 5% co-insurance, whichever is greater. On January 1 each year, the four drug payment stages start over.

 

You enter the Catastrophic Coverage Stage after $4,850 is reached (excluding premiums), you will have to pay only one of the following through the end of the year: $2.95 co-pay for generic drugs, $7.40 co-pay for brand name drugs or a 5% co-insurance, whichever is greater. On January 1 each year, the four drug payment stages start over.

 

Pharmacy Saver

Pharmacy SaverTM is a cost savings prescription drug program available to our plan members. UnitedHealthcare® has worked with many of our network pharmacies to offer even lower prices on many common prescription drugs. You may be able to pay less than your plan co-pay for your prescription drugs with the Pharmacy Saver program. Many prescriptions start at just $1.501.

Pharmacy SaverTM is a cost savings prescription drug program available to our plan members. UnitedHealthcare® has worked with many of our network pharmacies to offer even lower prices on many common prescription drugs. You may be able to pay less than your plan co-pay for your prescription drugs with the Pharmacy Saver program. Many prescriptions start at just $1.501.

Preferred Retail Pharmacy Network

UnitedHealthcare members1 can save money on thousands of prescription drugs through our Preferred Retail Pharmacy Network. We've worked with many retail pharmacies in your area to help you save money on your prescription co-pays.

UnitedHealthcare members1 can save money on thousands of prescription drugs through our Preferred Retail Pharmacy Network. We've worked with many retail pharmacies in your area to help you save money on your prescription co-pays.

OptumRx® Home Delivery

$0 co-pay for a 90-day supply of Tier 1 and Tier 2 medications with home delivery from OptumRx.2

Footnotes

Member may use any pharmacy in the network but may not receive preferred retail pharmacy pricing. Pharmacies in the Preferred Retail Pharmacy Network may not be available in all areas. Co-pays apply after deductible. The Preferred Retail Pharmacy Network is not available in Guam, American Samoa, U.S. Virgin Islands or Northern Mariana Islands.

[author reference for PRPN ACCESSIBILITY DISCLAIMER FOR PREFERRED PLANS]

UnitedHealthcare's pharmacy network offers limited access to pharmacies with preferred cost sharing in rural Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming. 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 pharmacies with preferred cost sharing, please call 1-866-255-4835 (TTY 711), 8 a.m.—8 p.m. local time, 7 days a week or consult the online pharmacy directory at www.uhcmedicaresolutions.com/health-plans/aarp-pharmacy.html.

[author reference for PRPN ACCESSIBILITY DISCLAIMER FOR SAVER PLUS PLANS]

UnitedHealthcare's pharmacy network offers limited access to pharmacies with preferred cost sharing in rural Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming. 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 pharmacies with preferred cost sharing, please call 1-866-460-8854 (TTY 711), 8 a.m.—8 p.m. local time, 7 days a week or consult the online pharmacy directory at www.uhcmedicaresolutions.com/health-plans/aarp-pharmacy.htm.

 

2 You are not required to use OptumRx to obtain a 90-day supply of your maintenance medication. New prescriptions from OptumRx should arrive within ten business days from the date the completed order is received and refill orders should arrive in about seven business days. Contact OptumRx anytime at 1-877-266-4832 (TTY 711).

 

OptumRx is an affiliate of UnitedHealthcare Insurance Company. $0 co-pay is applicable for tier 1 and tier 2 medications during the initial coverage phase and may not apply during the coverage gap; it does not apply during the catastrophic stage.

 

Footnotes

Member may use any pharmacy in the network but may not receive preferred retail pharmacy pricing. Pharmacies in the Preferred Retail Pharmacy Network may not be available in all areas. Co-pays apply after deductible. The Preferred Retail Pharmacy Network is not available in Guam, American Samoa, U.S. Virgin Islands or Northern Mariana Islands.

[author reference for PRPN ACCESSIBILITY DISCLAIMER FOR PREFERRED PLANS]

UnitedHealthcare's pharmacy network offers limited access to pharmacies with preferred cost sharing in rural Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming. 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 pharmacies with preferred cost sharing, please call 1-866-255-4835 (TTY 711), 8 a.m.—8 p.m. local time, 7 days a week or consult the online pharmacy directory at www.uhcmedicaresolutions.com/health-plans/aarp-pharmacy.html.

[author reference for PRPN ACCESSIBILITY DISCLAIMER FOR SAVER PLUS PLANS]

UnitedHealthcare's pharmacy network offers limited access to pharmacies with preferred cost sharing in rural Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota and Wyoming. 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 pharmacies with preferred cost sharing, please call 1-866-460-8854 (TTY 711), 8 a.m.—8 p.m. local time, 7 days a week or consult the online pharmacy directory at www.uhcmedicaresolutions.com/health-plans/aarp-pharmacy.htm.

 

2 You are not required to use OptumRx to obtain a 90-day supply of your maintenance medication. New prescriptions from OptumRx should arrive within ten business days from the date the completed order is received and refill orders should arrive in about seven business days. Contact OptumRx anytime at 1-877-266-4832 (TTY 711).

 

OptumRx is an affiliate of UnitedHealthcare Insurance Company. $0 co-pay is applicable for tier 1 and tier 2 medications during the initial coverage phase and may not apply during the coverage gap; it does not apply during the catastrophic stage.

 

*Once you reach the Coverage Gap Stage, you pay co-pays or co-insurance defined by your plan for all Tier 1 through Tier 5 drugs regardless of whether your full deductible has been met.

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Your Drug List

This table helps you estimate what your drug costs might be with this Medicare prescription drug plan. Get cost sharing and other helpful information, or create a drug list from the drugs you take.

Your Drug List  Edit Coverage Details Initial Coverage Stage Co-pay or Co-insurance*
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Qty {{drug.drugQuantity}} {{drug.drugFrequency}}
T{{drug.drugCost.formularyStatus.tier}} PA
pdf
ST
pdf
LA NC QL
${{drug.drugCost.costDuringInitialCoveragePeriod | portalCurrency}}
Estimated Total Annual Costs: View Details ${{drugCostforPlan.totalDrugCost | portalCurrency}}
Current Pharmacy Edit

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(Pharmacy Saver™)

(Pharmacy Saver™)

(Preferred Retail Pharmacy)

(Preferred Mail Service Pharmacy)

(Standard Network Pharmacy)

View ways to save
on your drug costs
Learn more

*Co-pay and co-insurance costs shown for Initial Coverage Stage. Your co-pays and co-insurance may change based on the drug payment stage you are in.

 

Drugs that are not on the plan's formulary and listed as "NC" (not covered) in the chart above may have quantity limits if we approve a formulary exception for you. Please contact UnitedHealthcare to see if quantity limits apply.

Learn more about drug payment stages

The co-pays/co-insurance listed above reflect pricing for a 90-day supply using home delivery from OptumRx®.

Drug Coverage Legend

 


PDF (Portable Document Format) files can be viewed with Adobe® Reader®. If you don't already have this viewer on your computer, download it free from the Adobe website.

 

 

  • T#   Drug Tier   
  • NC   Not Covered   
  • ST   Step Therapy   
  • QL   Quantity Limits   
  • LA   Limited Access   
  • PA   Prior Authorization   

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Plan Costs

Cost Description Monthly Cost Annual Cost
Plan Premium1

The monthly fee you pay to the plan for your health care. The amount shown does not include the Part B premium you already pay to the government. You must continue to pay your Medicare Part B premium if not otherwise paid for under Medicaid or by another third party.

Why is my premium $0?   

${{planDetailsValues.totalPremium | portalCurrency}} ${{planDetailsValues.totalPremium*12| portalCurrency}}
Drug Costs from Formulary
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Edit Drug List
Not included
Varies
---
Not Included
${{drugCostforPlan.totalDrugCost | portalCurrency}}
---
Not Included
Medical Benefits

Monthly out-of-pocket costs

Varies Varies
Optional Riders

Select the rider(s) below to add coverage to your plan costs.

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Estimated Annual Total (total is based on dollar values above):
${{addval*12+drugCostforPlan.totalDrugCost+planDetailsValues.totalPremium*12 | portalCurrency}}
${{addval*12+planDetailsValues.totalPremium*12 | portalCurrency}}

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Drug Cost Details

The following chart shows your prescription drug costs based on the drug list you created and the pharmacy you chose. Note: Your co-pays or co-insurance may change based on the drug payment stage you are in. Drugs that are not on the plan's formulary and listed as "Not Covered" in the chart below may have quantity limits if we approve a formulary exception for you. Please contact UnitedHealthcare to see if quantity limits apply. The Formulary may change at any time. You will receive notice when necessary.  

Your Drug List

Initial
Coverage
Stage

   

   

Coverage Gap
Stage

   

   

Catastrophic
Coverage
Stage

   

   

{{drug.drugDosage}}

Qty {{drug.drugQuantity}}

{{drug.drugFrequency}}

${{drug.drugCost.costDuringInitialCoveragePeriod | portalCurrency}} ${{drug.drugCost.costDuringCoverageGap | portalCurrency}} ${{drug.drugCost.costDuringCatastrophicCoverage | portalCurrency}}

Note: The co-pays/co-insurance listed above reflect pricing for a 90-day supply using home delivery from OptumRx®.

The 4 Drug Payment Stages

In every Medicare Part D plan, there are four drug payment stages.

Annual Deductible Stage
The Annual Deductible Stage applies when your plan has an annual deductible, in which case you (or others on your behalf) will pay your drug costs up to the amount of the deductible.

Initial Coverage Stage
In the Initial Coverage Stage, you (or others on your behalf) will pay a co-pay or co-insurance each time you fill a prescription, and the plan pays the rest. When your total drug costs paid by you (or others on your behalf) and the plan reach $2,960, you then move to the Coverage Gap Stage.

Coverage Gap Stage
During the Coverage Gap Stage, you (or others on your behalf) will pay no more than 65% of the total cost for generic drugs or 45% of the total cost for brand name drugs, for any drug tier until the total amount you (or others on your behalf) have paid reaches $4,700 in year-to-date out-of-pocket costs.

You may pay less if your plan has additional coverage in the gap.

Always use your Medicare Advantage member ID card during the coverage gap to get the plan's discounted drug rates. The money you spend using your card counts toward your out-of-pocket costs.

Catastrophic Coverage Stage
You enter the Catastrophic Coverage Stage after $4,700 is reached (excluding premiums), you will have to pay only one of the following through the end of the year: $2.65 co-pay for generic drugs, $6.60 co-pay for brand name drugs or a 5% co-insurance, whichever is greater. On January 1 each year, the four drug payment stages start over.

In every Medicare Part D plan, there are four drug payment stages.

Annual Deductible Stage
The Annual Deductible Stage applies when your plan has an annual deductible, in which case you (or others on your behalf) will pay your drug costs up to the amount of the deductible.

Initial Coverage Stage
In the Initial Coverage Stage, you (or others on your behalf) will pay a co-pay or co-insurance each time you fill a prescription, and the plan pays the rest. When your total drug costs paid by you (or others on your behalf) and the plan reach $3,310, you then move to the Coverage Gap Stage.

Coverage Gap Stage
During the Coverage Gap Stage, you (or others on your behalf) will pay no more than 58% of the total cost for generic drugs or 45% of the total cost for brand name drugs, for any drug tier until the total amount you (or others on your behalf) have paid reaches $4,850 in year-to-date out-of-pocket costs.

You may pay less if your plan has additional coverage in the gap.

Always use your Medicare Advantage member ID card during the coverage gap to get the plan's discounted drug rates. The money you spend using your card counts toward your out-of-pocket costs.

Catastrophic Coverage Stage
You enter the Catastrophic Coverage Stage after $4,850 is reached (excluding premiums), you will have to pay only one of the following through the end of the year: $2.95 co-pay for generic drugs, $7.40 co-pay for brand name drugs or a 5% co-insurance, whichever is greater. On January 1 each year, the four drug payment stages start over.