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Coverage and benefits
Get a quick overview of your plan benefits.
Important Information about your Part D Vaccine and Insulin Coverage
What You Pay for Vaccines – Our plan covers most adult Part D vaccines at no cost to you.
What You Pay for Insulin – You won’t pay more than $35 for a one-month supply of each insulin product covered by our plan. Refer to your plan materials.
UAW Trust PDP
2024 materials
Benefits and costs
| Benefit |
UAW Trust Medicare Rx PDP |
|---|---|
|
UAW Trust Medicare Rx PDP |
|
| Annual out-of-pocket maximum |
$1,500 for Tier 2 only |
| Annual out-of-pocket maximum | |
|
$1,500 for Tier 2 only |
|
| Deductible |
None - Member pays applicable copay |
| Deductible | |
|
None - Member pays applicable copay |
|
| Initial Coverage Stage |
Member pays applicable copay |
| Initial Coverage Stage | |
|
Member pays applicable copay |
|
| Coverage Gap (Donut Hole) |
Member pays applicable copay |
| Coverage Gap (Donut Hole) | |
|
Member pays applicable copay |
|
| Catastrophic Coverage Stage |
Member pays the “lesser of” either the Trust copay or percentage of the drug copay |
| Catastrophic Coverage Stage | |
|
Member pays the “lesser of” either the Trust copay or percentage of the drug copay |
|
| Prescription drug coverage |
Retail 31-day supply; same as 90-day mail order Tier 1 - $0 copay Tier 2 - $33 copay Tier 3 - $115 copay |
| Prescription drug coverage | |
|
Retail 31-day supply; same as 90-day mail order Tier 1 - $0 copay Tier 2 - $33 copay Tier 3 - $115 copay |