21 CTPF 2027 MEDICARE HEALTH INSURANCE HANDBOOK AARP® Medicare Supplement Insurance Plan F (UnitedHealthcare) with Express Scripts by Evernorth Health Services® (PDP) for CTPF Available to Medicare recipients who turned 65 prior to 2020 or in some instances, with a Medicare Part A Effective Date prior to 1/1/2020. BEHAVIORAL HEALTH SERVICES (Medicare covered services only) Outpatient: 100% after Medicare pays Inpatient: 100% after Medicare pays PRESCRIPTION DRUG BENEFITS Preferred Value Network Pharmacy* (up to 31-Day supply) $15 Generic copay $45 Preferred brand copay $65 Non-preferred brand copay $65 Specialty drugs Preferred Value Network Pharmacy* (up to 90-Day Supply) $37.50 Generic copay $112.50 Preferred brand copay $162.50 Non-preferred brand copay $162.50 Specialty drugs Express Scripts Mail Order (up to 90-Day Supply) $30 Generic copay $90 Preferred brand copay $130 Non-preferred brand copay $130 Specialty drugs Annual Brand Prescription Deductible $200 Coverage Prescription coverage is provided through the Initial Coverage gap and generally stays the same as the copays listed above. For 2027, you will stay in this stage until the total cost of your Part D drugs reaches $2,400. Once you reach this limit, you move on to the Catastrophic Coverage stage. Most members will not reach the Catastrophic Coverage stage. Non-Medicare Part D drugs are not covered (for example, lifestyle drugs for ED). Medicare Part B drugs, including diabetic supplies, are processed by your medical plan. Vaccinations Flu shots and shots to prevent pneumococcal infections are covered under Part B. Contact your Medicare drug plan for more information about vaccines. Important Pharmacy Notes Once your true out-of-pocket cost reaches $2,400, your copay will be reduced. Once you meet this cost threshold, the plan pays the full cost for your covered Part D drugs. If your plan covers additional drugs not normally covered by Medicare, you may have a cost share for such drugs covered under an enhanced benefit. Plan Comparisons: Medicare-Eligible Members Cigna Surround Group Supplement Plan with Express Scripts by Evernorth Health Services® (PDP) (mirrors Plan G) Available to Medicare recipients who turned 65 on or after 2020 (or Part A effective date on or after 1/1/2020). BEHAVIORAL HEALTH SERVICES (Medicare covered services only) (Part B deductible applies) Outpatient: 100% after Medicare pays Inpatient: 100% after Medicare pays PRESCRIPTION DRUG BENEFITS Preferred Value Network Pharmacy* (up to 31-Day supply) $15 Generic copay $45 Preferred brand copay $65 Non-preferred brand copay $65 Specialty drugs Preferred Value Network Pharmacy* (up to 90-Day Supply) $37.50 Generic copay $112.50 Preferred brand copay $162.50 Non-preferred brand copay $162.50 Specialty drugs Express Scripts Mail Order (up to 90-Day Supply) $30 Generic copay $90 Preferred brand copay $130 Non-preferred brand copay $130 Specialty drugs Annual Brand Prescription Deductible $200 Coverage Prescription coverage is provided through the Initial Coverage stage and generally stays the same as the copays listed above. For 2027, you will stay in this stage until the total cost of your Part D drugs reaches $2,400. Once you reach this limit, you move on to the Catastrophic Coverage stage. Most members will not reach the Catastrophic Coverage stage. Non-Medicare Part D drugs are not covered (for example, lifestyle drugs for ED). Medicare Part B drugs, including diabetic supplies, are processed by your medical plan. Vaccinations Flu shots and shots to prevent pneumococcal infections are covered under Part B. Contact your Medicare drug plan for more information about vaccines. Important Pharmacy Notes Once your true out-of-pocket cost reaches $2,400, your copay will be reduced. Once you meet this cost threshold, the plan pays the full cost for your covered Part D drugs. If your plan covers additional drugs not normally covered by Medicare, you may have a cost share for such drugs covered under an enhanced benefit. 21 *Non-preferred network copays are $5 more than stated copays
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