The first stage occurs at the beginning of your prescription drug coverage. This is the period when you pay for your prescription drugs in full until you meet your yearly deductible amount. After the deductible is met, you move into the Initial Coverage stage.
Some plans do not have a yearly deductible. Under these plans, you would begin in the Initial Coverage stage.
Often called the 'Initial Coverage Phase', you will pay the plan's copays or coinsurance until a total drug cost of $4,020 is reached for the 2020 plan year.
Often called the 'Donut Hole Phase', you will pay the full cost of the covered drug until your total out of pocket cost reaches $6,350 for the 2020 plan year. UCare Classic and UCare Total plans have coverage throughout the Gap for Tier 1 and Tier 2 generic drugs, where you will pay the plans copay. .
Often called the 'Catastrophic Phase’, you will likely have lower cost sharing through the end of the calendar year once you have reached $6,350 in out of pocket drug costs for the 2020 plan year. During this phase, you will pay $3.60 for Generic drugs and $8.95 for Brand drugs, or 5% coinsurance – whichever is greater.