|Prescription Coverage||Amount You Will Pay|
|Coverage in the Gap||$2 / $8 / $0 (Tiers 1, 2, 6)|
|Preferred Generic-Tier 1||$2 (30-day) [$0 mail]|
|Non-Preferred Generic-Tier 2||$8 (30-day)|
|Preferred Brand-Tier 3||$47 (30-day|
|Non-Preferred Brand-Tier 4||$100 (30-day)|
|Specialty Drugs-Tier 5||33% coinsurance|
|90-Day Supply Retail||2.5 times 30-day|
Rx Coverage in the Gap
Rx Coverage in the Gap for Generic Drugs only: $2/$8/$0 (Tiers 1, 2, 6).
Teladoc Virtual Visits
24/7 access to Teladoc's board-certified doctors by phone or video in all 50 states for a $0 copay.
Receive a $50 quarterly over-the-counter benefit at the pharmacy.
Rx 90-day Mail
Receive a 90-day refill for 2 times the price of a 30-day supply per tier.
Hearing & Vision
$0 annual hearing exam and two hearing aids per year; $299 / $599. Routine vision coverage of $0 per exam - $150 allowance.
Year-long gym membership at one of the participating fitness facilities.
Material ID: H2960_SCPWebsite_2020 (CMS Accepted) Last Updated 1/03/2020 Note: Some links below may take you out of the Senior Care Plus website
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