PriorityMedicare Rx Plan Details

When you only need prescription coverage

As a Medicare Part D prescription drug plan, PriorityMedicare Rx^SM offers savings on your prescriptions now and protects you from rising prescription costs in the future. It's available throughout Michigan.

Note: Priority Health is contracted with the federal government to provide Medicare coverage, including Medicare Part D.

Benefits	Coverage & Costs
Monthly premium	$36.601
Deductible	$275
Initial Coverage: After you pay your yearly $275 deductible, you pay the following until yearly drug costs2 reach $2510:
Retail Pharmacy
Generic on Approved Drug List	In-network $7 copay for a one-month (31-day) supply of drugs $21 copay for a three-month (90-day) supply of drugs Out-of-network $7 copay for a one-month (31-day) supply of drugs
Preferred Brand on Approved Drug List	In-network $28 copay for a one-month (31-day) supply of drugs $84 copay for a three-month (90-day) supply of drugs Out-of-network $28 copay for a one-month (31-day) supply of drugs
Non-Preferred Brand	In-network $56 copay for a one-month (31-day) supply of drugs $168 copay for a three-month (90-day) supply of drugs Out-of-network $56 copay for a one-month (31-day) supply of drugs
Long-Term Care Pharmacy
Generic on Approved Drug List	$7 copay for a one-month (31-day) supply of drugs
Preferred Brand on Approved Drug List	$28 copay for a one-month (31-day) supply of drugs
Non-Preferred Brand	$56 copay for a one-month (31-day) supply of drugs
Mail Order
Generic on Approved Drug List	$14 copay for a three-month (90-day) supply of drugs
Preferred Brand on Approved Drug List	$56 copay for a three-month (90-day) supply of drugs
Non-Preferred Brand	$112 copay for a three-month (90-day) supply of drugs
Coverage Gap: After your total yearly drug costs2 reach $2510, you pay 100% until your yearly out-of-pocket drug costs3 reach $4050.
Catastrophic Coverage after you reach $4,050 in out-of-pocket costs3	In-network $2.25 copay for generics and a few brand names $5.60 copay for most brand-names OR 5% of discounted cost4 (whichever is greater) Out-of-network $2.25 copay for generics and a few brand names $5.60 copay for most brand-names OR 5% of discounted cost4 (whichever is greater)

¹You must continue to pay your Medicare Part A and/or B premium if not otherwise paid for under Medicaid or by another third party. You may qualify for help with your premium. Find out here.
² Total prescription costs include the copays you pay AND the costs the plan pays in 2008.
³ Your out-of-pocket costs include what you pay for prescription drugs (copays and/or the percentage of the cost you pay) in 2008.
⁴ Priority Health's discount averages 16% on most brand-name drugs, 58% or more on generics.

Additional information

2008 PriorityMedicare Rx Summary of Benefits brochure (300KB PDF)
2008 Combined Plan Summary of Benefits brochure (531KB PDF)
2008 Evidence of Coverage (506KB PDF)
2008 Approved Drug List (184KB PDF)
2008 Pending Changes to Approved Drug List
2008 Pharmacy Directory (465KB PDF)
2008 Provider Directory (985KB PDF)
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