PROTECT YOURSELF FROM THE UNEXPECTED
With Medicare Part D coverage you don’t have to worry about the high cost of prescription drugs and with Rite Aid Envision Rx Plus you may reduce your out-of-pocket expenses for many of the drugs you already take.
Even if you are now enrolled in a Medicare Part D Plan, you should compare prices every year.
RITE AID ENVISIONRX PLUS ADVANTAGES
- $0 deductible
- $0 copay on over 500 generic drugs - even in the coverage gap
- National Pharmacy Network
- Customer service 24 Hours a Day, Every Day
 | |
| PLAN BENEFITS WITH RITE AID PHARMACIES | |
|---|---|
| Annual Deductible | $0 |
| Covered Drugs | A wide selection of Medicare-covered brand and generic drugs |
| Amount you pay until you and the plan pay $2,930 for covered prescription drug expenses (includes costs, co-payments, co-insurance and deductibles): | |
| 30-Day Supply at Retail Pharmacy | Tier 1 Preferred Generics: $0 Tier 2 Non-Preferred Generics: 20% Tier 3 Preferred Brand: 15% Tier 4 Non-Preferred Brand: 30% Tier 5 Specialty Drugs: 33% |
| 90-Day Supply at Mail-Order or Retail Pharmacy | Tier 1 Preferred Generics: $0 Tier 2 Non-Preferred Generics: 20% Tier 3 Preferred Brand: 15% Tier 4 Non-Preferred Brand: 30% Tier 5 Specialty Drugs: 33% |
| Amount you pay between $2,930 in total covered prescription drug expenses and the point at which you have paid $4,700 in out-of-pocket costs coverage gap: | |
| 30- or 90- Day Supply at Retail or Mail-Order Pharmacy | Tier 1 Preferred Generics: $0 Other Generics: 86% Brand: 50% |
| Amount you pay after $4,700 in annual out-of-pocket covered expenses: | |
| 30- or 90- Day Supply at Retail or Mail-Order Pharmacy | For generic drugs: For all other drugs (specialty drugs |
| * Benefits, formulary, pharmacy network, premium and/or co-payments/co-insurance may change January 1, 2013. A Medicare approved prescription drug plan. The benefit information provided herein is a brief summary, not a comprehensive description of benefits. For more information contact the plan. | |
Answers To Common Questions
With Rite Aid EnvisionRx Plus, can I fill my prescriptions at any Rite Aid pharmacy?
Yes. You can have your prescriptions filled at any of the more than 4,700 Rite Aid pharmacies, plus any other pharmacy in the Rite Aid EnvisionRx Plus national network – regardless of where you live. You can also order your prescriptions by mail using a mail-in form, by phone, or over the Internet, and they will be delivered anywhere in the U.S.
How do I find out if my prescriptions are covered by Rite Aid EnvisionRx Plus?
Rite Aid EnvisionRx Plus covers thousands of brand name and generic drugs–including many of the most commonly prescribed drugs. However, not all prescription drug plans cover the same drugs. To find out if your drug is covered by Rite Aid EnvisionRx Plus, call a Customer Service Representative at 1-877-309-4875 (TTY/TDD users call 711), or check our website at www.envisionrxplus.com/riteaid, or ask your Rite Aid pharmacist.
You may be able to get Extra Help to pay for your prescription drug premiums and costs. To see if you qualify for extra help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/7 days a week; The Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or Your State Medicaid Office. Beneficiaries must use network pharmacies to access their prescription drug benefit, except in non-routine circumstances, and quantity limitations, copayments and restrictions may apply.
For More Information Or To Enroll
Call a Rite Aid EnvisionRx Plus Customer Service Representative at 1-877-309-4875 (TTY/TDD users call 711), or check our website at www.envisionrxplus.com/riteaid.
Customer service 24 hours a day, every day
* A Medicare approved prescription drug plan. Beneficiaries must use network pharmacies to access their prescription drug benefit, except in non-routine circumstances, and quantity limitations, copayments and restrictions may apply. Other pharmacies are available in our network. Plans offered by Envision Insurance Company. A Medicare-approved Part D sponsor.
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