Mga Basic sa Plano sa Inireresetang Gamot

Magkumpara ng Mga Plano at Magpatala na Ngayon!

Medicare Part D prescription drug plans are also known as PDPs. Medicare Part D is a government program that offers prescription drug insurance to everyone who is entitled to Medicare Part A and/or enrolled in Medicare Part B.

When you are ready to decide on a plan, take the time to understand how the plans work. That way, you can make an informed decision and choose the plan that's right for you.

Iba-ibang Gamot ang Sinasaklaw ng Iba-ibang PDP

Ang pederal na pamahalaan ay may mga partikular na alituntunin para sa mga uri ng mga gamot na dapat naming saklawin at minimum na pamantayan ng mga benepisyong dapat naming sundin.

Ang bawat plano ay may pormularyo (isang listahan ng mga saklaw na gamot) na nakakatugon sa mga kinakailangang ito ayon sa hinihingi ng batas. Tandaan, hindi lahat ng plano ay magkakapareho. Puwedeng mag-iba-iba ang mga ito pagdating sa gastos o mga partikular na gamot na saklaw.

Kung mag-e-enroll ka sa isang Medicare Part D na plano, pakitingnan ang pormularyo ng plano para matiyak na matutugunan nito ang mga pangangailangan mo sa saklaw sa inireresetang gamot.

Kung Mayroon Kang Kasalukuyang Medicare Advantage na Plano

Kung may kasamang saklaw sa inireresetang gamot ang iyong Medicare Advantage Plan at sumali ka sa isang Medicare PDP, madi-disenroll ka sa iyong Medicare Advantage Plan at ibabalik ka sa Orihinal na Medicare kasama ng iyong Medicare PDP.

Multa sa Nahuling Pagpapatala sa Saklaw sa Gamot ng Medicare (Part D)

Ang multa para sa nahuling pagpapatala ay ang halagang idinaragdag sa inyong buwanang premium sa plano ng gamot ng Medicare (Part D). Puwede kayong pagmultahin para sa nahuling pagpapatala kung may panahong wala kayong saklaw sa gamot ng Medicare o iba pang kinikilalang pagsaklaw sa inireresetang gamot sa loob ng 63 araw o higit pa pagkatapos magwakas ng inyong inisyal na panahon ng pagpapatala. Sa pangkalahatan, kailangan ninyong bayaran ang multa hangga't mayroon kayong saklaw sa gamot ng Medicare.

Pagdating sa Saklaw, Mayroon Kang Mga Opsyon:

Puwede kang makakuha ng saklaw sa inireresetang gamot ng Medicare sa pamamagitan ng Medicare PDP (Part D).
Puwede kang mag-sign up para sa isang Medicare Advantage na plano (HMO o PPO) o iba pang planong pangkalusugan ng Medicare na nag-aalok ng saklaw sa inireresetang gamot ng Medicare.

Mas Malaking Matitipid. Mas Malawak ang Saklaw. Serbisyo sa Pangangalaga.

Nag-aalok ang Wellcare ng mga planong idinisenyo para tulungan ang mga kuwalipikado sa Karagdagang Tulong (Low Income Subsidy) kung saan posibleng magkaroon ng mga libre o mababang premium at copay ang mga miyembro kapag nakatala sila.
Available din ang mga planong may mababang premium sa lahat ng estado kung saan umaabot nang hanggang $0 ang mga copay kapag nag-fill sa mga preferred na parmasya
Nag-aalok din ang Wellcare ng mga planong walang deductible, ibig sabihin, magsisimulang saklawin ng plano ang mga gastos sa inireresetang gamot sa unang araw pa lang
Thousands of network pharmacies are available nationwide in our network including national, regional and local chains, grocers and independent pharmacies
Nakikipagtulungan kami sa mga preferred na parmasya para makatulong na makatipid ng pera ang mga miyembro. Kasama sa mga preferred na parmasya sa aming network ang maraming kilalang pambansa at panrehiyong retailer. Gagamitin ninyo ang aming tool na
Humanap ng Provider para maghanap ng preferred na parmasyang pinakamalapit sa inyo

Member Service representatives are ready to help you with any questions about your coverage or medications. For a complete list of drugs covered by our plan, please review our website or contact our member services department.

Mahalagang impormasyon

Mga Disclaimer

Mga Disclaimer

‘Ohana Health Plan, a plan offered by WellCare Health Insurance of Arizona, Inc.

Ang Wellcare ang brand ng Medicare para sa Centene Corporation, isang HMO, PPO, PFFS, PDP na plano na may kontrata sa Medicare at isang aprubadong Sponsor ng Part D. Ang aming mga D-SNP na plano ay may kontrata sa programang Medicaid sa estado. Ang pagpapatala sa aming mga plano ay nakadepende sa pag-renew ng kontrata.

Washington residents: “Wellcare” is issued by Wellcare of Washington, Inc.

Washington residents: “Wellcare” is issued by WellCare Health Insurance Company of Washington, Inc.

Washington residents: “Wellcare” is issued by Coordinated Care of Washington, Inc.

Washington residents: “Wellcare” is issued by Coordinated Care of Washington, Inc., a subsidiary of Centene Corporation.

“Wellcare” is issued by WellCare Prescription Insurance, Inc.

Bawat taon, sinusuri ng Medicare ang mga plano batay sa 5-star na sistema sa pag-rate.

Walang obligasyon ang mga wala sa network/hindi kinontratang tagapagkaloob na gamutin ang mga miyembro ng Plano, maliban sa mga emergency na sitwasyon. Tawagan ang numero ng aming customer service o tingnan ang inyong Katibayan ng Saklaw para sa higit pang impormasyon, kabilang ang pagbabahagi-sa-gastos (cost-sharing) na nalalapat sa mga serbisyong wala sa network.

Wellcare’s pharmacy network includes limited lower-cost, preferred pharmacies in rural areas of Georgia, Hawaii, Missouri, and Nebraska. 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 whether there are any lower-cost preferred pharmacies in your area, please call 1-866-892-8340 (TTY: 711) for Wellcare No Premium (HMO) in GA or consult the online pharmacy directory at www.wellcare.com/medicare; 1-877-457-7621 (TTY: 711) for Wellcare ‘Ohana No Premium (HMO) and Wellcare ‘Ohana Low Premium Open (PPO) in HI or consult the online pharmacy directory at www.wellcare.com/ohana; 1-833-444-9088 (TTY: 711) for Wellcare No Premium (HMO), Wellcare Giveback (HMO), and Wellcare Assist (HMO) in MO or consult the online pharmacy directory at www.wellcare.com/medicare; and 1-800-977-7522 (TTY: 711) for Wellcare No Premium (HMO), Wellcare Giveback (HMO), Wellcare No Premium Open (PPO), and Wellcare Assist Open (PPO) in NE or consult the online pharmacy directory at www.wellcarene.com.

Value-Added Items and Services (VAIS) are not plan benefits and are not covered by the plan. Plan enrollees are responsible for all costs.

Louisiana D-SNP members: As a Wellcare HMO D-SNP member, you have coverage from both Medicare and Medicaid. You receive your Medicare health care and prescription drug coverage through Wellcare and are also eligible to receive additional health care services and coverage through Louisiana Medicaid. Learn more about providers who participate in Louisiana Medicaid by visiting www.myplan.healthy.la.gov/en/find-provider or www.louisianahealthconnect.com. For detailed information about Louisiana Medicaid benefits, please visit the Medicaid website at https://ldh.la.gov/medicaid and select the “Learn about Medicaid Services” link. To request a written copy of our Medicaid Provider Directory, please makipag-ugnayan sa amin.

Louisiana D-SNP prospective enrollees: For detailed information about Louisiana Medicaid benefits, please visit the Medicaid website at https://ldh.la.gov/medicaid or www.louisianahealthconnect.com. To request a written copy of our Medicaid Provider Directory, please makipag-ugnayan sa amin.

Paunawa: Hindi pananagutan ng TennCare ang pagbabayad para sa mga benepisyong ito, maliban para sa mga naaangkop na halaga ng bahagi sa gastos. Hindi pananagutan ng TennCare ang paggarantiya sa pagiging available o sa kalidad ng mga benepisyong ito. Ang anumang benepisyong hindi kasama sa mga karaniwang benepisyo ng Medicare ay nalalapat lang sa Wellcare Medicare Advantage at hindi ito nagsasaad ng mas pinaraming benepisyo sa Medicaid.

Texas D-SNP members: As a Wellcare HMO D-SNP member, you have coverage from both Medicare and Medicaid. You receive your Medicare health care and prescription drug coverage through Wellcare and are also eligible to receive additional health care services and coverage through Texas Medicaid. Learn more about providers who participate in Texas Medicaid by visiting wellcarefindaprovider.com. For detailed information about Texas Medicaid benefits, please visit the Texas Medicaid website at www.hhs.texas.gov/services/health/medicaid-chip/medicaid-chip-members/starplus. To request a written copy of our Medicaid Provider Directory, please makipag-ugnayan sa amin.

Texas D-SNP prospective enrollees: For detailed information about Texas Medicaid benefits, please visit the Texas Medicaid website at www.hhs.texas.gov/services/health/medicaid-chip/medicaid-chip-members/starplus. To request a written copy of our Medicaid Provider Directory, please contact us.

Wellcare (HMO and HMO SNP) includes products that are underwritten by WellCare of Texas, Inc., WellCare National Health Insurance Company, and SelectCare of Texas, Inc.

Wellcare Dual Liberty (HMO-D-SNP) Plan

Wellcare Dual Liberty (HMO D-SNP) is a Fully Integrated Dual Eligible Special Needs Plan with a Medicare contract and a contract with the New Jersey Medicaid program. Enrollment in Wellcare Dual Liberty depends on contract renewal. This information is not a complete description of benefits. Contact the plan for more information. Limitations and restrictions may apply. Benefits may change on January 1 of each year. Your Part B premium is covered by Medicaid. This plan is available to those who have both Medicare and full Medicaid benefits. Wellcare uses a formulary. There is no obligation to enroll. Please contact Wellcare for details.

When joining this plan:

1.) You must use in-network providers, DME (durable medical equipment) suppliers, and pharmacies.

2.) You will be enrolled automatically into Medicaid (NJ FamilyCare) coverage under our plan and disenrolled from any Medicaid (NJ FamilyCare) plan you are currently enrolled in. All of your Medicaid-covered services, items, and medications will then be covered under our plan, and you must get them from in-network providers.

3.) You will be enrolled automatically into Part D coverage under our plan, and you will be automatically disenrolled from any other Medicare Part D or creditable coverage plan in which you are currently enrolled.

4.) You must understand and follow our plan’s rules on referrals.

Mga Disclaimer

Mga Disclaimer

‘Ohana Health Plan, a plan offered by WellCare Health Insurance of Arizona, Inc.

Ang Wellcare ang brand ng Medicare para sa Centene Corporation, isang HMO, PPO, PFFS, PDP na plano na may kontrata sa Medicare at isang aprubadong Sponsor ng Part D. Ang aming mga D-SNP na plano ay may kontrata sa programang Medicaid sa estado. Ang pagpapatala sa aming mga plano ay nakadepende sa pag-renew ng kontrata.

Washington residents: “Wellcare” is issued by Wellcare of Washington, Inc.

Washington residents: “Wellcare” is issued by WellCare Health Insurance Company of Washington, Inc.

Washington residents: “Wellcare” is issued by Coordinated Care of Washington, Inc.

Washington residents: “Wellcare” is issued by Coordinated Care of Washington, Inc., a subsidiary of Centene Corporation.

“Wellcare” is issued by WellCare Prescription Insurance, Inc.

Bawat taon, sinusuri ng Medicare ang mga plano batay sa 5-star na sistema sa pag-rate.

Walang obligasyon ang mga wala sa network/hindi kinontratang tagapagkaloob na gamutin ang mga miyembro ng Plano, maliban sa mga emergency na sitwasyon. Tawagan ang numero ng aming customer service o tingnan ang inyong Katibayan ng Saklaw para sa higit pang impormasyon, kabilang ang pagbabahagi-sa-gastos (cost-sharing) na nalalapat sa mga serbisyong wala sa network.

Wellcare’s pharmacy network includes limited lower-cost, preferred pharmacies in rural areas of Georgia, Hawaii, Missouri, and Nebraska. 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 whether there are any lower-cost preferred pharmacies in your area, please call 1-866-892-8340 (TTY: 711) for Wellcare No Premium (HMO) in GA or consult the online pharmacy directory at www.wellcare.com/medicare; 1-877-457-7621 (TTY: 711) for Wellcare ‘Ohana No Premium (HMO) and Wellcare ‘Ohana Low Premium Open (PPO) in HI or consult the online pharmacy directory at www.wellcare.com/ohana; 1-833-444-9088 (TTY: 711) for Wellcare No Premium (HMO), Wellcare Giveback (HMO), and Wellcare Assist (HMO) in MO or consult the online pharmacy directory at www.wellcare.com/medicare; and 1-800-977-7522 (TTY: 711) for Wellcare No Premium (HMO), Wellcare Giveback (HMO), Wellcare No Premium Open (PPO), and Wellcare Assist Open (PPO) in NE or consult the online pharmacy directory at www.wellcarene.com.

Value-Added Items and Services (VAIS) are not plan benefits and are not covered by the plan. Plan enrollees are responsible for all costs.

Louisiana D-SNP members: As a Wellcare HMO D-SNP member, you have coverage from both Medicare and Medicaid. You receive your Medicare health care and prescription drug coverage through Wellcare and are also eligible to receive additional health care services and coverage through Louisiana Medicaid. Learn more about providers who participate in Louisiana Medicaid by visiting www.myplan.healthy.la.gov/en/find-provider or www.louisianahealthconnect.com. For detailed information about Louisiana Medicaid benefits, please visit the Medicaid website at https://ldh.la.gov/medicaid and select the “Learn about Medicaid Services” link. To request a written copy of our Medicaid Provider Directory, please makipag-ugnayan sa amin.

Louisiana D-SNP prospective enrollees: For detailed information about Louisiana Medicaid benefits, please visit the Medicaid website at https://ldh.la.gov/medicaid or www.louisianahealthconnect.com. To request a written copy of our Medicaid Provider Directory, please makipag-ugnayan sa amin.

Paunawa: Hindi pananagutan ng TennCare ang pagbabayad para sa mga benepisyong ito, maliban para sa mga naaangkop na halaga ng bahagi sa gastos. Hindi pananagutan ng TennCare ang paggarantiya sa pagiging available o sa kalidad ng mga benepisyong ito. Ang anumang benepisyong hindi kasama sa mga karaniwang benepisyo ng Medicare ay nalalapat lang sa Wellcare Medicare Advantage at hindi ito nagsasaad ng mas pinaraming benepisyo sa Medicaid.

Texas D-SNP members: As a Wellcare HMO D-SNP member, you have coverage from both Medicare and Medicaid. You receive your Medicare health care and prescription drug coverage through Wellcare and are also eligible to receive additional health care services and coverage through Texas Medicaid. Learn more about providers who participate in Texas Medicaid by visiting wellcarefindaprovider.com. For detailed information about Texas Medicaid benefits, please visit the Texas Medicaid website at www.hhs.texas.gov/services/health/medicaid-chip/medicaid-chip-members/starplus. To request a written copy of our Medicaid Provider Directory, please makipag-ugnayan sa amin.

Texas D-SNP prospective enrollees: For detailed information about Texas Medicaid benefits, please visit the Texas Medicaid website at www.hhs.texas.gov/services/health/medicaid-chip/medicaid-chip-members/starplus. To request a written copy of our Medicaid Provider Directory, please contact us.

Wellcare (HMO and HMO SNP) includes products that are underwritten by WellCare of Texas, Inc., WellCare National Health Insurance Company, and SelectCare of Texas, Inc.

Wellcare Dual Liberty (HMO-D-SNP) Plan

Wellcare Dual Liberty (HMO D-SNP) is a Fully Integrated Dual Eligible Special Needs Plan with a Medicare contract and a contract with the New Jersey Medicaid program. Enrollment in Wellcare Dual Liberty depends on contract renewal. This information is not a complete description of benefits. Contact the plan for more information. Limitations and restrictions may apply. Benefits may change on January 1 of each year. Your Part B premium is covered by Medicaid. This plan is available to those who have both Medicare and full Medicaid benefits. Wellcare uses a formulary. There is no obligation to enroll. Please contact Wellcare for details.

When joining this plan:

1.) You must use in-network providers, DME (durable medical equipment) suppliers, and pharmacies.

2.) You will be enrolled automatically into Medicaid (NJ FamilyCare) coverage under our plan and disenrolled from any Medicaid (NJ FamilyCare) plan you are currently enrolled in. All of your Medicaid-covered services, items, and medications will then be covered under our plan, and you must get them from in-network providers.

3.) You will be enrolled automatically into Part D coverage under our plan, and you will be automatically disenrolled from any other Medicare Part D or creditable coverage plan in which you are currently enrolled.

4.) You must understand and follow our plan’s rules on referrals.