Quartz Dual Eligible Members
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.
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. Each 30-day supply will take one copay at a retail pharmacy. A 90-day supply equals three copays.
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.
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
|||Deductible||Retail 30-day||Retail 60-Day||Retail 90-Day||Mail Order|
|Tier 1 (Preferred Generic)||$505||25% of cost||25% of cost||25% of cost||25% of cost|
|Tier 2 (Generic)||$505||25% of cost||25% of cost||25% of cost||25% of cost|
|Tier 3 (Preferred Brand)||$505||25% of cost||25% of cost||25% of cost||25% of cost|
|Tier 4 (Non-Preferred Drug)||$505||25% of cost||25% of cost||25% of cost||25% of cost|
|Tier 5 (Specialty)||$505||25% of cost||Not offered||Not offered||Not offered|
|Tier 6 (Vaccines)||$0||$0||Not offered||Not offered||Not offered|
Initial Coverage Gap begins at: $4,660 | Catastrophic Coverage begins at: $7,400