- Magellan Rx offers prescription drug coverage in five states, as well as in Washington, D.C.
- Magellan offers one Medicare Part D plan: Magellan Rx Medicare Basic.
- This plan has a monthly premium and a $435 deductible in all covered states.
- Members can save on copayments by using Magellan’s preferred pharmacies.
Magellan Rx has been offering its Medicare Part D plan, Magellan Rx Medicare Basic, since 2016. The plan is available to customers in the Mid-Atlantic region and in Arizona.
The plan offers significant discounts for members who buy their prescriptions at preferred pharmacies. These include both small local pharmacies and large chains like CVS and Walmart.
Let’s find out where these plans are offered, costs, and more.
As of 2020, you can get the Magellan Rx Medicare Part D plan in five states and Washington, D.C. The states where it’s available are:
- New York
The Magellan Part D plan is offered statewide in these five states. This means that no matter where in the state you live, the plan will be available to you.
Important changes for 2021
Magellan Rx is not renewing its contract with Medicare and will not offer Medicare Part D prescription drug plans in 2021.
If you currently have a Part D plan through Magellan Rx, you will need to join another Medicare prescription drug plan by December 31, 2020, to avoid a lapse in coverage.
You can find out what carriers are offering plans in your area in 2021 by entering your ZIP code in Medicare’s plan finder tool.
Magellan Rx offers one Part D plan: Magellan Rx Medicare Basic. The plan has different costs depending on where you live, but the plan name and general coverage details will be the same.
The plan has a monthly premium and a deductible you’ll need to meet before your prescriptions are covered. The Magellan Rx Medicare Basic plan offers coverage at local pharmacies as well as mail-order pharmacies.
Magellan Rx Medicare Basic is a stand-alone Medicare Part D prescription drug plan. It provides coverage for prescriptions in five categories, or tiers:
- Tier 1: preferred generic
- Tier 2: generic
- Tier 3: preferred brands
- Tier 4: nonpreferred brands
- Tier 5: specialty
Magellan Rx members can save on their costs by using a preferred pharmacy.
Preferred pharmacies include major chains and small local pharmacies. Major chains include:
- Food Lion
- Harris Teeter
In addition to prescription drug coverage, members who take multiple medications are also eligible for the Medication Therapy Management (MTM) program.
You can join the MTM program if you:
- take at least eight prescriptions
- have complex medical conditions
- have a very high annual prescription cost
The MTM program helps you understand every medication you’re taking. If you’re part of the program, you can have a medication review with a pharmacist at no cost.
Plus, your pharmacist will review your medications regularly to look for any interaction issues. They’ll report anything they spot to your doctor.
Your costs will depend on the state where you live. Like all Medicare Part D plans, your costs are in addition to your costs for original Medicare, which is made up of Medicare Part A (hospital insurance) and Medicare Part B (medical insurance).
Most people receive Part A without paying a premium, but you must pay a premium for Part B. In 2020, the standard Part B premium is $144.60.
When you use a Part D plan, you’ll pay both the premium for your Part D plan and the premium for Part B.
If you have limited income, you may qualify for the Extra Help program, which helps pay your Part D premiums. On the other hand, if you have a higher income, you may pay slightly higher amounts for your Part D premium.
In the table below, you can check out common costs for the Magellan Rx Medicare Basic plan in some covered cities.
|Richmond, VA||Baltimore, MD||Utica, NY||Flagstaff, AZ|
|Preferred pharmacy tier 1 generics||$1||$1||$1||$1|
|Standard pharmacy tier 1 generics||$8||$8||$8||$8|
|Preferred pharmacy tier 3 preferred brands||$27||$30||$25||$25|
|Standard pharmacy tier 3 preferred brands||$40||$40||$25||$25|
Medicare parts A and B are also known as original Medicare. Original Medicare doesn’t include prescription drug coverage. You can get prescription coverage by adding a Part D plan to your original Medicare.
You might also need a Part D plan if you use Medicare Advantage (Part C). While many Medicare Advantage plans include prescription drug coverage, not all do. If your Medicare Advantage plan doesn’t include prescription drug coverage, you can buy a separate Part D plan.
Part D plans are offered by private insurance companies that contract with Medicare. The plans available to you will depend on where you live. Part D plans have a network of pharmacies where you can get the most coverage.
They also have a list of medications they’ll cover, called a formulary. The formulary includes prescriptions on each of the five tiers, from generics to specialty. Your Part D plan won’t cover a medication that isn’t listed on its formulary.
You can shop for plans in your area and find one that covers the prescriptions you currently take by using Medicare’s plan finder tool.
You can enter your ZIP code, current prescriptions, and pharmacy. You’ll be matched with plans in your area that include your medications in their formulary, and you’ll be able to see the cost to you.
Medicare Part D plans are optional. However, Medicare does require that you have some form of prescription drug coverage. You’re able to use drug coverage you have from another source, like an employer, as long as it covers the same basics as Medicare Part D plans.
You’ll pay penalties in the form of higher premiums later if you don’t have coverage and don’t sign up for Medicare Part D when you’re first eligible. The penalty will increase for each month you don’t have coverage.
Magellan Rx offers Part D coverage in Arizona, Delaware, Maryland, New York, Virginia, and Washington, D.C.
The Magellan Rx Medicare Basic plan is offered throughout all covered states. The plan covers generic, name brand, and specialty prescriptions.
Members can save on their costs by using any of the plan’s preferred pharmacies.
This article was updated on November 20, 2020, to reflect 2021 Medicare information.
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