Order an enrollment kit or contact one of our Medicare experts.
See our 2022 additional benefits page for more information.
Essential | ||
Deductible (applies to tiers 3-5): $250 | ||
1 month/30 days | 3 month/90 days | |
Preferred retail and mail order | Tier 1: $0 Tier 2: $5 Tier 3: $40 Tier 4: $90 Tier 5: 28% cost sharing | Tier 1: $0 Tier 2: $10 Tier 3: $100 Tier 4: $270 Tier 5:not applicable |
Standard retail | Tier 1: $7 Tier 2: $12 Tier 3: $47 Tier 4: $100 Tier 5: 28% cost sharing | Tier 1: $7 Tier 2: $24 Tier 3: $117.50 Tier 4: $300 Tier 5: not applicable |
Coverage gap (donut hole) | 25% coinsurance | |
Catastrophic coverage | Generic: 5% or $3.95 Brand: 5% or $9.85 |
Prevea360 Harmony does not offer Part D Prescription Harmony (HMO POS) MA Only Drug coverage. This is an excellent choice if you already have prescription drug coverage through Wisconsin’s Senior Care Prescription Drug Assistance Program, TRICARE for Life, the VA or an employer plan. You cannot have a Medicare Part D Prescription Drug plan if you enroll in the Harmony plan.