紅藍卡 (Medicare) 處方藥付款計劃
This plan is a new payment option that works with the current EasyCare (HMO) drug coverage. It helps you manage out-of-pocket Medicare Part D drug costs by spreading them across the calendar year (January to December). If you select this payment option, each month you’ll continue to pay the plan premium (if there is one), and will get a bill from the EasyCare to pay for prescription drugs, instead of paying at the pharmacy. Even though you won’t pay for drugs at the pharmacy, you will still be responsible for the costs of the prescription drugs. If you want to know your drug cost before you take it home, you can call the plan or ask the pharmacist at the pharmacy.
There’s no cost to participate in the Medicare Prescription Payment Plan. Participation is voluntary. See how to sign up below.
此付款方式可能有助於您管理每月開支，但無法為您省錢或降低藥物費用。
有關詳細資訊，請查看紅藍卡說明書：
It depends on your situation. This payment option might help you manage your monthly expenses, but it doesn’t save you money or lower drug costs. You will benefit from participating in the Medicare Prescription Payment Plan if you have high drug costs earlier in the calendar year. Although you can start participating in this payment option at any time in the year, starting earlier (like before September), gives you more months to spread out your drug costs before year ends. Click here to find out if you are likely to benefit from this payment option.
在以下情況下，此付款方式可能不是您的最佳選擇：
- 每年的藥物費用較低。
- 每月的藥物費用相同。
- 您不想變更支付藥物費用的方式。
- 您有資格獲得紅藍卡的額外補助。
- 您有資格參加紅藍卡節省計劃。
- 您從其他組織獲得支付藥物費用的幫助，如州政府醫藥補助計劃 (SPAP)、優惠券計劃或其他健康保險。
There are three ways to sign up:
- Online at www.medimpact.com
- Call 1-888-672-7205
- Download this form and follow the instructions: English, Spanish, Chinese
Once your request is received and reviewed, you’ll be sent a letter confirming your participation into the Medicare Prescription Payment Plan.
This is what happens next:
- When you get a prescription for a drug covered by Part D, your plan will automatically let the pharmacy know that you’re participating in this payment option, and you won’t pay the pharmacy for the prescription. Even though you won’t pay for your drugs at the pharmacy, you’re still responsible for the costs. If you want to know what your drug will cost before you take it home, call your plan or ask the pharmacist.
- Each month, your plan will send you a bill with the amount you owe for your prescriptions, when it’s due, and information on how to make a payment. You’ll get a separate bill for your monthly plan premium (if you have one).
- 您可以查看計算方式的例子（第 6 頁）並參考 CMS 的此情況說明書以獲取更多資訊。
- 在一個日曆年（1 月至 12 月）中，您支付的費用絕不會超過：
- 在您不參與此付款計劃的情況下，您將需向藥房支付的費用總額。
- 紅藍卡藥物承保的年度自付費用上限（2025 年為 $2,000）。
- 處方藥法規將 2025 年的藥物自付費用上限設為 $2,000。 對於擁有紅藍卡藥物保險的每個人來說都是如此，即使您不參加紅藍卡處方藥付款計劃也是如此。
您的結算週期和付款通知將從您選擇加入該計劃後的次月開始。 由於您可以在計劃年度內隨時選擇加入，因此付款計算方式可能每個月都會有所變化。 當您獲取新處方（或續配現有處方）時，未來的付款可能會有所增加。這是因為隨著新的自付費用被納入到您的每月付款中，用於分攤剩餘款項的月份相對更少了。 每個月，我們都會向您寄送一張賬單，其中包含您所欠的處方藥金額、到期時間以及如何付款的資訊。 對於您的月繳計劃保費（如有），您將收到一份單獨的賬單。請務必先支付您的健保或藥物計劃的每月保費（如有），以免失去您的藥物承保。 如果您擔心同時要支付每月計劃保費和紅藍卡處方藥付款計劃的賬單，請參閱上文部分，瞭解可以幫助降低費用的計劃的相關資訊。
We encourage you pay the bill once received so the next month’s bill doesn’t increase due to non-payment. You will get reminders from us if you miss a payment but won’t be charged an interest or fees. After two months of missed payments, we will remove you from the Medicare Prescription Payment Plan and send you a letter to inform. You will NOT be disenrolled from EasyCare. You can also leave the Medicare Prescription Payment Plan program at any time, if you feel it is not right for you. If you are removed from the program or you choose to leave the program before making full payments of balance owed, keep in mind:
- 如果您仍有欠款，即使您不再參加此付款計劃，您也需要支付所欠金額。
- 您可以選擇一次性支付所有欠款或按月支付。
- 退出紅藍卡處方藥付款計劃後，您將直接向藥房支付新的藥物自付費用。
自 2025 年 1 月 1 日起，您可以在一年內的任何時間選擇加入紅藍卡處方藥付款計劃。 請記住，如果您在一年內較晚時間（9 月之後）加入，則此付款方式可能不是您的最佳選擇。 這是因為隨著新的自付費用被納入到您的每月付款中，用於分攤剩餘款項的月份相對更少了。
如果您選擇在 2025 年加入此計劃，一旦您的新計劃年度開始，我們將在收到您的請求後 24 小時內確認您的參與，與您聯絡以收集任何缺失的資訊或提供拒絕理由來拒絕您的參與。 如果等待 24 小時以透過紅藍卡處方藥付款計劃配取處方藥會對您的健康造成風險，您仍然可以選擇加入該計劃，根據緊急情況所需從藥房配取處方藥，並在您獲准參與後，請求我們透過紅藍卡處方藥付款計劃來調整處方藥賠付。 如果這些賠付是在收到您的參與請求的三天前提出的，我們將重新處理您的處方藥賠付，並報銷您在藥房支付的款項。 一旦您的參與獲得批准，您的藥房將收到通知，以透過紅藍卡處方藥付款計劃提交您的處方藥賠付。
For Grievances, call, 1-866-783-1444 (TTY: 711). 8 am–8 pm, weekdays.
For questions about Medicare Prescription Payment Plan, call, 1-888-672-7205. You can call the same number, at any time of the year, if you’d like opt-out of participating in the Medicare Prescription Payment Plan if you decide it is not right for you.
You may pay the amount due for the respective month or full amount due over the year as a lump-sum.
You may send checks to:
- TBD (this is still being finalized).
如果您有無法自動符合低收入津貼（也稱作額外輔助）的限制收入和資源，您將需要申請此津貼，並由社會安全局或紐約州衛生署確定您的資格。
如有關於處方藥費用額外輔助的問題，或需要協助來填寫申請表：
- 請致電 1-800-772-1213 (TTY: 1-800-325-0778) 聯絡社會安全局。
- 您也可以在社會安全局網站上填寫申請表。
要透過信件獲得申請表的其他副本，請致電 1-800-MEDICARE (1-800-633-4227)，服務時間為每週七天，每天 24 小時。 TTY 使用者請致電 1-877-486-2048。
此外，如果您需要填寫申請的協助，請致電 1-866-783-1444 (TTY: 711) 聯絡我們。