Wisconsin Medicare Prescription Drug Plans

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WPS Health Insurance is a Medicare-approved Part D sponsor

Medicare beneficiaries may enroll in WPS MedicareRx Plan through the Centers for Medicare & Medicaid Services (CMS) Online Enrollment Center, located on the official Medicare.gov website.

Call Us Toll-Free
1-800-731-0459 (TTY: 711)

Hours of Operation:
8 a.m. to 8 p.m., weekdays (year-round) and weekends (Oct. 1–March 31)

To view performance ratings for WPS MedicareRx Plan, visit the official Medicare.gov website. Benefits, formulary, pharmacy network, premiums, and/or copayments may change on Jan. 1 of each year. Please contact WPS Health Insurance for details.

The benefit information provided is not comprehensive. Additional information should be requested before making a decision about your coverage

If you qualify for extra help with your Medicare prescription drug plan costs, your premium and costs at the pharmacy will be lower. When you join WPS MedicareRx Plan (PDP), Medicare will tell us how much extra help you are getting. Then we will let you know the amount you will pay. If you are not getting this extra help, you can see if you qualify by contacting:

  • 1-800-MEDICARE (1-800-633-4227, TTY: 877-486-2048), 24 hours a day, seven days a week
  • The Social Security Office at 1-800-772-1213 (TTY: 1-800-325-0778), 7 a.m. to 7 p.m., Monday through Friday
  • Your State Medicaid Office

If you continue to qualify for the same amount of help next year, the chart below tells you how your prescription costs will change.


If you pay up to this much this year (2020) You will pay up to this much next year (2021)
$0 deductible $0 deductible
$89 deductible $92 deductible
$1.30 for generics and brands that are treated as generics $3.90 for brand name drugs $1.30 for generics and brands that are treated as generics $4.00 for brand name drugs
$3.60 for generics and brands that are treated as generics $8.95 for brand name drugs $3.70 for generics and brands that are treated as generics $9.20 for brand name drugs
No more than 15% coinsurance for all drugs No more than 15% coinsurance for all drugs

If you qualify for extra help, you pay a reduced monthly premium. If you continue to qualify for the same amount of extra help in 2021, the table below tells how much you will pay for a monthly premium. (This doesn't include any Medicare Part B premium you may have to pay.) If you don't know your level of extra help, call us.


Your level of extra help Monthly Premium
WPS MedicareRx Plan 1 WPS MedicareRx Plan 2
100% $38.60 $91.60
75% $48.80 $101.80
50% $58.90 $111.90
25% $69.10 $122.10

You may receive (or may have already received) a letter from Medicare or Social Security about your 2021 eligibility for extra help. Read this important information carefully. If you don't know what level of extra help you qualify for, you can call 1-800-MEDICARE (1-800-633-4227, TTY: 877-486-2048), 24 hours a day, seven days a week.

2021 WPS MedicareRx Plan (PDP) Monthly Plan Premium
For people who get extra help from Medicare to help pay for their prescription drug costs

Federal regulations at 42 CFR § 423.1-800 specify the requirements of Part D sponsors in the administration of the low-income subsidy program, including the reduction of cost sharing for subsidy-eligible individuals. In certain cases, CMS systems do not reflect a beneficiary's correct low-income subsidy (LIS) status at a particular point in time. As a result, the most up-to-date and accurate subsidy information has not been communicated to the Part D plan.

To address these situations, CMS created the best available evidence (BAE) policy in 2006. This policy requires sponsors to establish the appropriate cost-sharing for low-income beneficiaries when presented with evidence that the beneficiary's information is not accurate.

Go to the CMS website Best Available Evidence Policy page

 

Call today for a free info kit!

Contact your local agent or call us at 1-800-731-0459 (TTY: 711)
8 a.m.-8 p.m., weekdays (year-round) and weekends (Oct. 1—March 31).