TEAMStar Part D Bronze - $250 deductible
Monthly Premium $29*
What Do You and TEAMStar Part D Bronze Pay?
Summary of Benefits |
Initial Coverage | TEAMStar Part D Bronze has a $250 deductible that must be met on all drugs, except Preferred Generics. After you meet your deductible for applicable drugs, you pay the copay or coinsurance for the prescriptions you receive. For Preferred Generic drugs, you only pay the $6 copay. However, you will only pay a $2 copay for a one-month supply from a list of certain Preferred Generics (i.e. Low Cost Generics) purchased at a “Union Preferred Pharmacy.” |
| $2,930 | The Coverage Gap (The Donut Hole) |
The coverage gap begins when you and TEAMStar have spent $2,930 on drugs. While you are in the Coverage Gap, you will receive a discount on covered brand name drugs and you only pay 86% of the costs for generic drugs |
| $4,700 | Catastrophic Coverage | Catastrophic coverage begins when you have spent $4,700 on drugs. For the rest of the year, you pay the greater of $2.60 for generic drugs (including brand drugs that are treated like generics), and $6.50 for all other drugs or 5% coinsurance. We pay the rest. However, you will pay no more than $100 per prescription. |
*Monthly premiums are reduced to $28 for the Bronze plan if you elect to pay premiums by monthly bank draft. Note: Monthly premium shown does not reflect any Medicare imposed penalties for late enrollment or IRMAA.
Explanation of Benefits
You receive an Explanation of Benefits (EOB) every month. The EOB shows you what drug costs we covered. The EOB also tracks your spending and ours, so you always know how close you are to the gap
updated 10/01/11
