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Level 1 participants are required to pay a $5 copayment for each covered generic prescription drug, and a $15 copayment for each covered brand name prescription drug. When there is no generic equivalent, the participant will still have to pay the $15 brand name copay. If a participant has private insurance with a higher copayment per prescription than SeniorCare, the SeniorCare copayment rules will apply, and benefits will be coordinated with the private insurance company. Providers who have questions regarding billing/benefit coordination should contact Provider Services at 1-800-947-9627. Residents of nursing homes and community-based residential facilities will have to pay the usual SeniorCare copayment even when they are required to purchase drugs on less than a monthly basis. 39.11.3 Level 2a: Deductible Level 2a participants have an annual deductible of $500. The participant will get a discount off the retail price for most covered prescription drugs during the deductible period. The discount amount depends on the particular drug prescribed. After this deductible is met, a level 2a participant is required to pay a $5 copayment for each covered generic prescription drug and a $15 copayment for each covered brand name prescription drug. When there is no generic equivalent, the participant will still have to pay the $15 brand name copay. 39.11.4 Level 2b: Deductible Level 2b participants have an annual deductible of $850. The participant will get a discount off the retail price for most covered prescription drugs during the deductible period. The discount amount depends on the particular drug prescribed. After this deductible is met, a level 2b participant is required to pay a $5 copayment for each covered generic prescription drug, and a $15 copayment for each covered brand name prescription drug. When there is no generic equivalent, the participant will still have to pay the $15 brand name copay. Note: If married persons in the same FTG with annual income above 160% of FPL are determined non-financially eligible at different times, the deductible amount is prorated for the spouse who applies later (see SECTION 33.9.3.1 FTG CHANGES AT LEVEL 2A AND 2B) 39.11.5 Level 3: Spenddown Level 3 participants must meet a spenddown. The amount of spenddown is the difference between the FTG annual income and 240% of the FPL corresponding to the size of the FTG. The SeniorCare program tracks the amount spent on covered prescriptions drugs that can be applied to an applicant’s spenddown. 39.11.5.1 Level 3: Fiscal Test Group of One A SeniorCare participant considered as a FTG of one with gross annual income above 240% FPL pays retail prices for covered prescription drugs until those payments equal the spenddown amount.