- SilverScript Medicare Part D plans are available nationwide.
- Members have access to more than 65,000 pharmacies across the United States.
- SilverScript offers two Medicare Part D plan options.
SilverScript is part of the CVS Health family of companies and is one of the largest companies offering Medicare Part D coverage in the United States. SilverScript offers Part D plans in all 50 states.
The company offers two different plans, including one with a $0 deductible. Members of both plans have access to a large network of more than 65,000 pharmacies, as well as to CVS mail pharmacy service.
SilverScript offers two different Part D plans: SilverScript Choice and SilverScript Plus.
SilverScript Choice is available to residents of all 50 states. SilverScript Plus is available to residents of every state except Alaska. Both plans are available to residents of Washington, D.C.
You can get Medicare Part D coverage from both SilverScript plans. The plans offer similar coverage.
The primary difference is the out-of-pocket cost for each plan.
SilverScript Plus has a $0 deductible. The SilverScript Choice plan has no deductible for generic prescriptions but does have one for any name brand or specialty drugs.
Another difference between the two plans is coverage during the period known as the Part D “donut hole.” The donut hole is a coverage gap between the limit you and your plan can spend during the year and a “catastrophic” level of coverage.
While you’re in the donut hole, your prescription drug copay costs will vary, depending on your SilverScript plan:
- SilverScript Choice. You’ll pay25 percent of the cost of all generic, brand name, and specialty prescriptions.
- SilverScript Plus. You’ll pay your standard copay for all generics and 25 percent of the cost of brand name and specialty prescriptions.
Your coverage will be the same under either SilverScript plan. The only difference will be the cost to you for that coverage.
SilverScript plans include:
- $0 copays for preferred generics
- access to a network of more than 65,000 pharmacies
- lower copays at more than 20,000 preferred pharmacies
- access to savings for 90-day mail-order refills through CVS Caremark Mail Service Pharmacy
Members who meet certain criteria are also eligible for SilverScript’s Medication Therapy Management Program. The program provides a free consultation with a pharmacist to help you understand all the medications you’re taking and answer any questions you have.
The program will also communicate with your doctor to make sure all your prescriptions are the best option for you. You’ll automatically be enrolled in the program if you meet one of the three following conditions:
- You take more than eight prescription drugs.
- You have three or more chronic conditions.
- You’ve reached $4,255 in prescription costs in a single year.
SilverScript will let you know when you qualify and help you schedule a free appointment with a pharmacist.
Premiums for SilverScript plans range from $21 to $101 per month, depending on where you live and on the plan you choose.
Like all Part D plans, the premium for your SilverScript plan is in addition to the other costs you pay for Medicare. Some parts, like Part A and Part B, have standard costs, while other parts have costs that depend on which plan you have.
There’s no premium for Part A, but Part B has a monthly premium of $144.60 in 2020. So, if you’re using original Medicare (parts A and B together), you’ll need to pay the Part B premium and the premium for your SilverScript Plan.
If you have a Medicare Advantage or Medigap plan, you’ll pay the premium for that plan, your Part B premium, and the premium for your Part D plan.
Your copays with SilverScript will depend on your plan and on your prescriptions. Examples of premiums and deductibles for both SilverScript plans are shown in the table below.
|Boston, MA||Atlanta, GA||Cincinnati, OH||Portland, OR||Albuquerque, NM|
|SilverScript Choice||$33.10 monthly premium; $275 annual deductible for brand name and specialty drugs||$23.30 monthly premium; $320 annual deductible for brand name and specialty drugs||$30.80 monthly premium; $380 annual deductible for brand name and specialty drugs||$31.30 monthly premium; $245 annual deductible for brand name and specialty drugs||$23.30 monthly premium; $315 annual deductible for brand name and specialty drugs|
|SilverScript Plus||$89.80 monthly premium; $0 annual deductible||$70.50 monthly premium; $0 annual deductible||$76.80 monthly premium; $0 annual deductible||$85 monthly premium; $0 annual deductible||$79.50 monthly premium; $0 annual deductible|
Medicare parts A and B, also known as original Medicare, don’t offer coverage for prescription drugs. Medicare Part A is hospital insurance for inpatient stays, while Medicare Part B is medical insurance for services like doctor’s appointments and urgent care visits.
Medicare Part D allows you to add prescription drug coverage to original Medicare.
Part D is made up of stand-alone plans offered by private insurance companies. All Part D plans are overseen by Medicare and need to follow Medicare’s regulations.
The Medicare Part D plans available to you will depend on where you live. Some plans, like SilverScript, are available nationwide — but many plans are available only in select states or regions.
What are Part D formularies?
All Part D plans have a list of prescriptions they’ll cover. This list is called a formulary.
Your plan’s formulary will divide prescriptions into groups, called tiers. The tiers for prescription plan formularies are typically broken down like this:
- tier 1: preferred generic
- tier 2: generic
- tier 3: preferred
- tier 4: nonpreferred
- tier 5: specialty
Your plan will have a set copay for each tier.
For example, both SilverScript plans cover tier 1 prescriptions with a $0 copay. You’ll generally pay a larger copay the higher the tier of your prescription.
How do I find the right Part D plan for me?
You can search for plans in your area that include any prescriptions you currently take by using Medicare’s plan finder tool.
It allows you to enter any prescriptions you take, along with personal information like your ZIP code. You’ll then be matched with plans that include your current prescriptions in their formulary.
Do I have to enroll in a Part D plan?
You’re not required to have a Part D plan if you have Medicare, but you do need to have prescription drug coverage. You’ll pay a late enrollment penalty if you don’t have prescription coverage at all, and the fee increases with each month you don’t have adequate coverage.
Medicare allows you to get this coverage from other sources, such as your employer’s health plan.
You can also get coverage by selecting a Medicare Advantage (Part C) plan that includes Part D coverage. A Medicare Advantage plan that includes Part D allows you to have all your coverage in one plan.
You can search for plans in your area on the Medicare website.
SilverScript offers two different Medicare Part D plans nationwide. SilverScript Choice is available in all 50 states, while SilverScript Plus is available in every state except Alaska.
Both plans offer $0 copays for tier 1 generics and access to more than 65,000 pharmacies.
The SilverScript Plus plan has no deductible and more coverage during the Part D donut hole, while the SilverScript Choice plan offers low monthly premiums.
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