MDA Retiree Medical Plan
MDA insurance exclusively offers two unique MDA Retiree Medical plans that pay eligible expenses that Medicare does not pay. These plans are administered through AmWINS Group Benefits and insured by United American Insurance Company and are accepted anywhere that Medicare is accepted. To be eligible to participate, an MDA member and/or spouse must either be age 65 or older or under age 65 and disabled, and be enrolled in Medicare Part A and Part B.
Plan 1
Plan 1 is closed as of January 1, 2018. Benefits are for those currently enrolled only.
- Part A Deductible: $0
- Part B Deductible: $0
- Prescription Drug Deductible: $0 (See chart below for prescription drug benefits.)
- Click here for the Plan 1 Schedule of Benefits*
* This plan is no longer available for new enrollees as of 12/31/16.
Plan 2
- Part A Deductible: $0
- Part B Deductible: $203
- Prescription Drug Deductible: $0 (See chart below for prescription drug benefits.)
- Click here for the Plan 2 Schedule of Benefits
Plan 3
- Part A Deductible: $0
- Part B Deductible: $203 (Plus $20 copay per office visit)
- Prescription Drug Deductible: $0 (See chart below for prescription drug benefits.)
- Click here for the Plan 3 Schedule of Benefits
4-Tier Medicare Part D Plan – Basic
This plan offers a 4-tier co-payment plan for prescription drugs. This is a plan with a $275 Brands Only Deductible. You will be responsible for a co-payment for your prescription drugs.
Annual Deductible $275.00 Brands Only | ||
---|---|---|
Level | 30-Day Retail Co-Pay | 90-Day Mail Order Co-Pay
Preferred Pharmacies/ Standard Pharmacies |
Tier 1 – Generic Drugs | $10 | $20/$30 |
Tier 2 – Preferred Brand Drugs | $50 | $100/$150 |
Tier 3 – Non-Preferred Brand | $105 | $210/$315 |
Tier 4 – Specialty Drugs
Coverage Gap (Donut Hole): Generics Only |
30%
|
30%/30%
|
After your total yearly drug costs reach $4,660, you will pay the same copay schedule as noted above for Generic Drugs only. Member copays on Brand Drugs will be 25%. If your out-of-pocket costs reach $7,400 (“Catastrophic Limit”) your co-payment will be reduced to the greater of a $4.15 co-payment for generic drugs (including brand drugs treated as generic) and a $10.35 co-payment for all other drugs, or a 5% co-insurance.
5-Tier Medicare Part D Plan – Enhanced
This plan offers a five tier co-payment plan for prescription drugs. This is a plan with no annual deductible. You will be responsible for a co-payment for your prescription drugs.
Annual Deductible $0 | ||
---|---|---|
Level | 30-Day Retail Co-Pay | 90-Day Mail Order Co-Pay |
Tiers 1 & 2 – Preferred and Non-Preferred Generic Drugs Pay this copay even in the Part D donut hole |
$10 | $20 |
Tier 3 – Preferred Brand Drugs Pay this copay even in the Part D donut hole |
$45 | $90 |
Tier 4 – Non-Preferred Brand Pay this copay even in the Part D donut hole |
50% ($70 min.-$100 max) |
50% ($140 min.-$200 max) |
Tier 5 – Specialty Drugs Pay this copay even in the Part D donut hole |
30%
($500 max) |
30%
($1000 max) |
After your total yearly drug costs reach $4,660, you will pay the same copay schedule as noted above. If your out-of-pocket costs reach $7,400 (“Catastrophic Limit”) your co-payment will be reduced to the greater of a $4.15 co-payment for generic drugs (including brand drugs treated as generic) and a $10.35 co-payment for all other drugs, or a 5% co-insurance.
Customer Service Commitment
AmWINS and MDA Insurance are committed to providing the highest quality services to those participating in our group Retiree Health plan that supplements Medicare. To that end, you may call either MDA Insurance or AmWINS Group Benefits.
MDA Insurance is available from 8 a.m. until 5 p.m. Monday through Friday at 877.906.9924.
AmWINS Group Benefits is available from 8 a.m. to 8 p.m. Monday through Friday at 877.248.7595
Any time you have a question about your benefit or claim, call MDA Insurance or AmWINS Group Benefits for a courteous, knowledgeable and prompt response.