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.

PriorityMedicare Rx
Monthly premium	$38.401
Deductible	$0
Initial Coverage: You pay the following until YOUR yearly drug costs2 reach [$2,700]:
Here's what you pay at retail pharmacies for:
Generic	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	In-network $42 copay for a one-month (31-day) supply of drugs $126 copay for a three-month (90-day) supply of drugs Out-of-network $42 copay for a one-month (31-day) supply of drugs
Non-preferred brand	In-network $65 copay for a one-month (31-day) supply of drugs $195 copay for a three-month (90-day) supply of drugs Out-of-network $65 copay for a one-month (31-day) supply of drugs
Specialty (usually injectable; must be ordered from a specialty pharmacy)	In-network 33% coinsurance for a one-month (31-day) supply of drugs Out-of-network 33% coinsurance for a one-month (31-day) supply of drugs
Here's what you pay at long-term care pharmacies for:
Generic	$7 copay for a one-month (31-day) supply of drugs
Preferred brand	$42 copay for a one-month (31-day) supply of drugs
Non-preferred brand	$65 copay for a one-month (31-day) supply of drugs
Specialty (usually injectable; must be ordered from a specialty pharmacy)	In-network 33% coinsurance for a one-month (31-day) supply of drugs Out-of-network 33% coinsurance for a one-month (31-day) supply of drugs
Here's what you pay using the PriorityMedicare mail service pharmacy for:
Generic	$17.50 copay for a three-month (90-day) supply of drugs
Preferred brand	$105 copay for a three-month (90-day) supply of drugs
Non-preferred brand-name	$162.50 copay for a three-month (90-day) supply of drugs
Coverage Gap:
After your total yearly drug costs2 reach $2,700, you pay 100% until your yearly out-of-pocket drug costs3 reach $4,350.
Catastrophic Coverage after you reach $4,350 in out-of-pocket DRUG costs3
Generics (and a few brand-name drugs)	In-network $2.40 copay OR 5% of discounted cost4 (whichever is greater) Out-of-network $2.40 copay OR 5% of discounted cost4 (whichever is greater)
Most brand name drugs	In-network $6.00 copay OR 5% of discounted cost4 (whichever is greater) Out-of-network $6.00 copay 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 2009.
³ Your out-of-pocket costs include what you pay for prescription drugs (copays and/or the percentage of the cost you pay) in 2009.
⁴ Priority Health's discount averages 16% on most brand-name drugs, 58% or more on generics.

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