|2014 WPS MedicareRx Plan 2|
|Tier 1 - Preferred Generic drugs||$3|
|Tier 2 - Non-preferred generic drugs||$13|
|Tier 3 - Preferred brand drugs||$42|
|Tier 4 - Non-preferred brand drugs||47%|
|Tier 5 - Specialty brand drugs||33%|
|Initial coverage limit||$2,850|
|Gap coverage||$3 preferred generics, $13 non-preferred generics, all others you pay no more than 47.50% (after a 50% manufacturer discount on covered brand-name drugs)|
|Catastrophic coverage (After your yearly out-of-pocket costs reach $4,550)||The greater of $2.55 for generics* and $6.35 for all others, or 5%; whichever is greater.|
|State and national pharmacy network||Yes|
|Mail order drugs (90 day supply)||2.5 times
This plan provides access to the brand-name and generic drugs included in our Medicare-approved formulary.
As part of health care reform legislation, drug manufacturers will provide discounts to enrollees who are in the coverage gap. You will save 50% on covered brand-name drugs while inside the "donut hole" at the time of purchase.
Unless otherwise noted, copay and coinsurance amounts shown above are what you pay for a 30-day supply.
*Including covered brand-name drugs treated as generic.