at a glance
- WPS offers Medicare Part D plans to residents of Wisconsin.
- WPS has a network that includes pharmacies in all 50 states.
- There are two different Part D plans available through WPS.
- The WPS MedicareRx Plan 2 has no deductible.
Wisconsin Physicians Service (WPS) is based in Madison, Wisconsin, and has been serving members throughout the state since 1946. Today the company offers various types of insurance coverage, including Medicare Part D plans.
WPS has two Medicare Part D plans available. Both plans allow members to access a broad network of pharmacies, as well as low copayments on generic prescriptions.
WPS offers two different Part D plans:
- WPS MedicareRx Plan 1. Plan 1 is a basic Part D plan designed for members who don’t expect to use many medications. It also offers low premiums.
- WPS MedicareRx Plan 2. Plan 2 is designed for members who may have a lot of prescription drug needs. This plan provides some extra benefits to help bring down your out-of-pocket costs.
Both plans offer similar coverage. The primary difference is that Plan 1 has a deductible, whereas Plan 2 doesn’t. Plus, Plan 2 offers more coverage during a Part D coverage gap known as the “donut hole.”
For example, if you have the WPS MedicareRx Plan 1, you’ll pay a 25 percent coinsurance cost for generics during the donut hole. However, the WPS MedicareRx Plan 2 offers generics at no cost during the donut hole.
Both of the WPS Part D plans offer prescription coverage and access to the nationwide WPS network. Other coverage you’ll find with both plans includes:
- brand-name drug coverage
- generic drug coverage
- discounted prices on 90-day mail-order supplies
- access to the Medication Therapy Management (MTM) program, which helps members manage multiple prescriptions and answers any prescription drug questions
Many Part D plans have different prices in each area or city they cover. This isn’t the case with WPS plans.
The two WPS plans have the same standardized costs throughout Wisconsin.
In the table below, you can get a closer look at some of the costs associated with each plan in 2021.
| WPS MedicareRx Plan 1 | WPS MedicareRx Plan 2 | |
|---|---|---|
| Monthly premium | $79.30 | $132.30 |
| Annual deductible | $445 | $0 |
| 30-day supply tier 1 (preferred generic) | $3 | $0 |
| 30-day supply tier 2 (generic) | $15 | $11 |
| 30-day supply tier 3 (preferred brand) | $42 | $42 |
| 30-day supply tier 4 (nonpreferred) | 49% coinsurance | 45% coinsurance |
| 30-day supply tier 5 (specialty) | 25% coinsurance | 33% coinsurance |
| donut hole tier 1 | 25% coinsurance | $0 |
| donut hole tier 2 | 25% coinsurance | $11 |
| donut hole tiers 3–5 | 25% coinsurance | 25% coinsurance for tiers 3 and 4, 33% coinsurance for tier 5 |
As you can see, you’ll pay more each month for Plan 2, but your overall out-of-pocket costs will be less than with Plan 1.
Choosing the right plan for you will depend on your budget, the number of prescriptions you take, and what tier your prescription medications are in.
Note that your cost for any Part D plan is in addition to the cost of your other Medicare coverage.
Asking the right questions can help you select a Part D plan that meets your needs. Check out the answers to a few commonly asked questions about finding a Part D plan.
How do I check which medications are covered by WPS prescription drug benefits?
You can search the list of covered drugs on the WPS website by entering your medications to see whether they’re covered and if there are any special requirements for coverage.
You can also call WPS directly at 800-731-0459 to ask about coverage and costs.
Plans can change what medications they cover, so check your coverage and your plan’s formulary every year to make sure your medications are still covered.
How do I find a WPS Medicare Advantage prescription drug plan or stand-alone Medicare prescription drug plan that covers my medications?
Depending on your medication needs and budget, you can search the WPS prescription drug plans for 2021 by ZIP code to find the best choice for you.
You can also use this pharmacy finder tool to search pharmacies by ZIP code.
Medicare plan search toolMedicare also offers its own plan search tool for finding Advantage and Part D plans. This tool includes fields to enter your medications and preferred pharmacies.
You can search by ZIP code and compare coverage and costs for multiple plans from different companies.
Medicare Part D is coverage for prescription drugs.
Because neither part of original Medicare (parts A and B) includes coverage for prescription drugs you take at home, private insurance companies like WPS contract with Medicare to offer Part D plans.
These plans must follow regulations set by Medicare. For example, Medicare won’t allow Part D plans to cover certain medication types.
Medicare also regulates the out-of-pocket maximum that Part D plans can have. In 2021, plans need to have an out-of-pocket maximum of $6,550 or less.
WPS offers Medicare Part D plans throughout the state of Wisconsin. The company offers two plan options to meet members’ prescription drug coverage needs.
WPS offers access to a nationwide network of pharmacies, meaning that members can get prescriptions filled while they’re away from home. Coverage also includes access to the MTM program, which can help members manage and understand their prescriptions.