Pay less for certain Part B or Part D covered insulin and drugs.
If you use insulin that is covered under Medicare Part B (on all CarePlus plans) or Part D (on CarePlus plans with prescription drug coverage), the most you will pay for a one-month supply (up to 30 days) is $35.
All CarePlus plan members are eligible for this Part B insulin copay limit. It includes insulin dispensed through a pump or Medicare-covered durable Medicare equipment, but it does not apply to the pump itself.
Members enrolled in a plan with prescription drug coverage are eligible for this Part D insulin copay limit. Members never pay more than $35 for any covered insulin on any prescription drug tier and in any coverage stage, even the deductible stage, if applicable.
Every 3 months, Medicare determines a list of rebatable Medicare Part B drugs to help reduce costs for Medicare enrollees. This means that plans may not require members to pay more than the coinsurance limit set by Medicare for these drugs, even if the plan's stated member coinsurance is higher. Medications that Medicare lists have a reduced coinsurance amount, meaning the percentage you pay is lower than before.
All CarePlus plan members are eligible for these Part B medication savings. These savings do not apply to Part D prescription drugs.
Here is the current list of rebatable Medicare Part B drugs. We update this list every 3 months.
Previous rebate lists:
CarePlus plans with prescription drug coverage cover most Part D vaccines at no cost to you. This includes the shingles vaccine and all vaccines recommended by the Advisory Committee on Immunization Practices (ACIP).1
If your plan has a prescription drug deductible, your copay is $0 for these vaccines even if you haven’t reached your deductible.
Effective Jan. 1, 2025, the Medicare Part D Coverage Gap stage or “donut hole” is eliminated. On CarePlus plans with prescription drug coverage, once a member pays $2,000 out-of-pocket for plan-covered prescription drugs, member enters the Catastrophic stage.
All CarePlus members enrolled in a plan with prescription drug coverage pay $0 for all plan-covered prescription drugs once they reach the Catastrophic Stage. This includes any Part D excluded drugs that are covered by CarePlus. See the plan’s Prescription Drug Guide for coverage details.
Effective Jan. 1, 2025, members enrolled in plans with prescription drug coverage can opt in to the Medicare Prescription Payment Plan.
After opting in to the Medicare Prescription Payment Plan:
1Restrictions based on age and vaccine availability may apply. Visit the
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CarePlus is an HMO plan with a Medicare contract. Enrollment in CarePlus depends on contract renewal.
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