UCare Connect + Medicare (HMO D-SNP) 2023 Part D (Prescription Drug) Coverage

Members of UCare Connect + Medicare get Medicare Part D prescription drug coverage. This means that Medicare pays for part of their prescription drugs.

Our list of covered prescription drugs, also called a formulary, can be easily searched using our Formulary Search Tool. There is also an option to print the entire formulary.

The following prescription copays apply based on the person’s living situation and income level.

If you are in a nursing home, long-term care facility, or receiving home and community based services:

• You pay $0 for brand name drugs.
• You pay $0 for generic drugs.

If your income is at or below 100% of federal poverty guidelines:

• You pay $4.30 for brand name drugs.
• You pay $1.45 for generic drugs.

If your income is over 100% of federal poverty guidelines:

• You pay $10.35 for brand name drugs.
• You pay $4.15 for generic drugs.

After your yearly out-of-pocket drug costs reach $7,400, you will have no copay.

Generally, you must get your prescription drugs from contracted pharmacies in UCare’s network. To find out if your pharmacy is in UCare’s network, use the Search Network tool.

Because you have Medicaid (Medical Assistance), you qualify for Extra Help to pay for some of your prescription drug costs. For more information about Extra Help, call:

• 1-800-MEDICARE (1-800-633-4227), TTY users call 1-877-486-2048 24 hours a day, 7 days a week,

• Your state Medicaid office, or

• The Social Security Administration at 1-800-772-1213, 7 am – 7 pm, Monday – Friday. TTY users call 1-800-325-0778.

You can also find information on the Medicare, state Medicaid office, and Social Security Administration websites (external sites).

Copays and coinsurance may vary based on the level of Extra Help received. Contact us for further details.

If you get Extra Help from Medicare, your monthly Part B premium and some prescription drug costs will be lower than what you would pay if you did not get Extra Help from Medicare. The amount of Extra Help you get will determine the cost of your monthly Part B premium.