2022 Banner Medicare Simple Rx (PDP) By Banner Medicare Rx



Banner Medicare Simple Rx (PDP) is a Basic Alternative 2022 Medicare (Part-D) Prescription Plan by Banner Medicare Rx. Stand-alone plans offer additional prescription drug coverage only and are an option if you are on Original Medicare insurance or you have a Medicare health plan that does not include Part D coverage. The Banner Medicare Simple Rx (PDP) plan has a monthly drug premium of $37.40 and a $480.00 drug deductible.



S3147-001 Part-D Summary of Bennefits

Plan Name:
Banner Medicare Simple Rx (PDP)
Provider: Banner Medicare Rx
Plan ID:
S3147-001
Plan Year:2022
State: Arizona
Benefit Type: Basic
Monthly Drug Premium: $37.40
Drug Deductible: $480.00
Tiers with No Deductible: 0
Gap Coverage: No
National Plan: No
Similar Plan: S3147-002


Deductible and Premium for Banner Medicare Simple Rx (PDP)

The Banner Medicare Simple Rx (PDP) plan has a monthly drug premium of $37.40 and a $480.00 drug deductible. This Banner Medicare Rx plan offers a $37.40 Part D Basic Premium that is below the regional benchmark. This covers the basic prescription benefit only and does not cover enhanced drug benefits such as medical benefits or hospital benefits. The Part D Supplemental Premium is $0.00 this Premium covers any enhanced plan benefits offered by Banner Medicare Rx above and beyond the standard PDP benefits. This can include additional help in the gap, lower co-payments and coverage of non-Part D drugs. The Part D Total Premium is $37.40 . The Part D Total Premium is the combined total of the supplemental and basic premiums for some plans this amount can be lower due to negative premiums.



Part D Basic Premium: $37.40
Benchmark: below the regional benchmark
Part D Supplemental Premium $0.00
Benefit Type: Basic Alternative
Total Part D Premium: $37.40


Banner Medicare Rx Premium Assistance

Depending on your income level you may be eligible for full 75%, 50%, 25% premium assistance. The Banner Medicare Simple Rx (PDP) medicare insurance plan offers a $0.00 premium obligation if you receive a full low-income subsidy (LIS) assistance. And the payment is $9.30 for 75% low income subsidy $18.70 for 50% and $28.00 for 25%.



$0 Premium with Full LIS: Yes
Full LIS Premium: $0.00
75% LIS Premium: $9.30
50% LIS Premium: $18.70
25% LIS Premium: $28.00


S3147-001 Gap Coverage

In 2022 once you and your plan provider have spent $4130 on covered drugs. (combined amount plus your deductible) You will be in the coverage gap. (AKA "donut hole") You will still receive a 75% discount on covered brand-name drugs and a discount on generic drugs. Once you reach the coverage gap you will pay 25% of the plans cost for covered brand-name prescription drugs and 25% on generic drugs unless your plan offers additional coverage. This Banner Medicare Rx plan does not offer additional coverage through the gap. If you are looking for additional health coverage you can see the Arizona MA Plans here.



S3147-001 Formulary or Drug Prices

Banner Medicare Simple Rx (PDP) formulary is divided into tiers or levels of coverage based on usage and according to the medication costs. Each tier will have a defined copay that you must pay to receive the drug. Drugs in lower tiers will usually cost less than those in higher tiers. By reviewing different Medicare Drug formularies, you can pick a Medicare Advantage plan that covers your medications. Additionally, you can choose a plan that has your drugs listed at a lower price. You can see complete 2022 Banner Medicare Simple Rx (PDP) S3147-001 Formulary here.

Drug Tier Copay
Preferred
Pharmacy
Copay
Nonpreferred
Pharmacy
Tier 1 0.0000 $0
Tier 2 0.0000 $11
Tier 3 0.0000 22%
Tier 4 0.0000 38%
Tier 5 0.0000 25%
*Initial Coverage Phase and 30 day supply







Source: CMS.
Plans as of September 1, 2021.
Notes: Data are subject to change. All contracts for 2020 have been not finalized. For 2020, enhanced alternative plans may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part Includes 2020 approved contracts/plans. Employer sponsored 800 series plans and plans under sanction are excluded.

*Licensed Agent Disclaimer: We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE (TTY users should call 1-877-486-2048) 24 hours a day/7 days a week to get information on all of your options.

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