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Quartz Dual Eligible Members

Drug coverage

The copay is the amount you pay when you get a prescription filled. A copay may be a flat-dollar amount or a percentage of the total cost of a drug.

Drug maintenance

Prescriptions are often sold in 30-day supplies. However, you can buy up to a 90-day supply of medications in Tiers 1 through 4.

If you live in a long-term care facility, your copay is the same as in a retail pharmacy.

You can get prescriptions from an out-of-network pharmacy, but you may pay more.

2024 Copay amounts

Extra help copay if you have Low Income Subsidy (LIS) Level 3

Retail 30-dayRetail 60-dayRetail 90-day Mail order
3-month
 Generic drugs$0$0$0$0
 Brand/other drugs$0$0$0$0
 Vaccines$0$0$0$0

Extra help copay if you have LIS Level 2

Retail 30-dayRetail 60-dayRetail 90-day Mail order
3-month
 Generic drugs$1.55$1.55$1.55$1.55
 Brand/other drugs$4.60$4.60$4.60$4.60
 Vaccines$0$0$0n/a

Extra help copay if you have LIS Level 1

Retail 30-dayRetail 60-dayRetail 90-day Mail order
3-month
 Generic drugs$4.50$4.50$4.50$4.50
 Brand/other drugs$11.20$11.20$11.20$11.20
 Vaccines$0$0$0$0

Standard Part D benefit – Does not receive Extra Help

Retail 30-dayRetail 60-dayRetail 90-day Mail order
3-month
 Generic and Brand/other drugsDeductible
$545, then 25%
coinsurance
Deductible
$545, then 25%
coinsurance
Deductible
$545, then 25%
coinsurance
Deductible
$545, then 25%
coinsurance
Insulins$35$70$105$105
 Vaccines
(Cost-sharing Tier 6)
$0n/an/an/a
Note:

2023 Copay amounts

Part D vaccines are covered at no cost to you.  You won’t pay more than $35 for a one-month supply of covered insulin, no matter what cost-sharing tier it’s on.

Quartz Medicare Advantage Dual Eligible plans
DeductibleRetail 30-dayRetail 60-DayRetail 90-Day Mail Order
90-Day
 Tier 1 (Preferred Generic)$50525% of cost25% of cost25% of cost25% of cost
 Tier 2 (Generic)$50525% of cost25% of cost25% of cost25% of cost
 Tier 3 (Preferred Brand)$50525% of cost25% of cost25% of cost25% of cost
 Tier 4 (Non-Preferred Drug) $50525% of cost25% of cost25% of cost25% of cost
 Tier 5 (Specialty)$50525% of costNot offeredNot offeredNot offered
Tier 6 (Vaccines)$0$0Not offeredNot offeredNot offered

Initial Coverage Gap begins at: $4,660 | Catastrophic Coverage begins at: $7,400

Quartz Dual Eligible Drug Information

Looking for information on your drug plan? Reach out to your Quartz Champion or check your formulary (drug list).