WPS Health Insurance

WPS offers three MedicareRx plan options so you can choose one that’s right for you.

Our Standard Plan features a $275 deductible and our lowest premium.

The Standard Plan is a good option if you anticipate low yearly drug costs.

Enhanced Plan 1 features a $0 deductible and predictable copays for brand-name and generic drugs.

Plan 1 is a good choice if you’re looking for a no-deductible plan with a low monthly premium.

Enhanced Plan 2 provides the same great benefits as Plan 1, plus coverage for generic drugs in the coverage gap or “doughnut hole.”

Plan 2 is a good choice if you anticipate yearly drug costs higher than $2,500 and you generally take generic medications.

All three plan options provide the same outstanding access to the brand-name and generic drugs included in our Medicare-approved comprehensive formulary. Use the chart below to compare plans.

Explore Our 2008 Plans

WPS MedicareRx Plans
	Standard Plan	Enhanced Plan 1	Enhanced Plan 2
Monthly premium	$41.60	$45.30	$71.30
Annual deductible	$275	$0	$0
Generic drugs	25%	$6	$6
Preferred brand drugs	25%	$37	$37
Non-preferred brand drugs	The greater of $20 or 25%	$57	$57
Specialty brand drugs	25%	33%	33%
Initial coverage limit	$2,510	$2,510	$2,510
Gap coverage	None	None	$6 generics, all others you pay 100%
Catastrophic coverage (After your yearly out-of-pocket costs reach $4,050)	The greater of $2.25 for generics* and $5.60 for all others or 5%	The greater of $2.25 for generics* and $5.60 for all others or 5%	The greater of $2.25 for generics* and $5.60 for all others or 5%
State and national pharmacy network	Yes	Yes	Yes
Mail order drugs (3-month supply)	25%**	2.5 times 30-day copay	2.5 times 30-day copay
Free Prilosec OTC	Yes	Yes	Yes

Unless otherwise noted, copay and coinsurance amounts shown above are what you pay for a 30 day supply.

The chart above highlights plan benefits. Please refer to the Summary of Benefits and Evidence of Coverage for complete plan details.

*Including brand-name drugs treated as generic.
**The greater of $40 or 25% for non-preferred brand drugs.

Wisconsin Physicians Service Insurance Corporation (WPS Health Insurance) contracts
with the Federal government to provide this Medicare Prescription Drug Plan.
©2008 Wisconsin Physicians Service Insurance Corporation. All Rights Reserved.

S5753_23259_021_0801

CMS Approved: 1/2008

Last Updated on 11/15/2007