Even if you have Medicare Parts A and B coverage, you may still need extra coverage for your prescription drugs. So, like a lot of people with Medicare, you might be looking at Medicare Part D, especially Medicare Silverscript, which is the cheapest way to cover prescription drugs on the market. It’s not surprising that many Medicare recipients are choosing a Silverscript plan as a way to save money. Could one fit your needs?
Part D of Medicare is the plan for prescription drugs. Some of a Medicare recipient’s medicine costs are covered by these drug plans. Medication costs can add up quickly, and if you don’t have insurance, you may have to pay a lot out of pocket. Medicare Part D plans help pay for the prices of prescription drugs so that people who need them can get them.
Medicare is made up of different parts, or sections, that cover different types of health care. Part A and Part B are the parts of Original Medicare. Prescription drugs are not covered by either of these plans. On the other hand, there are Medicare Advantage Plans, also called Medicare Part C, that are given by private insurance companies. Some of these plans may cover Part D, but not all of them do. If someone with Original Medicare or a Medicare Advantage Plan without a Part D plan wants coverage for prescription drugs, they would need to sign up for a different Medicare Part D plan, like SilverScript.
SilverScript
SilverScript is a private insurance company that merged with Aetna in January of 2020 and offers Medicare Part D plans. It covers prescription drugs for people with Original Medicare. Coverage choices are available in all 50 states and Washington, D.C. People who are qualified for Medicare Part D can choose from three different plans from SilverScript. Each plan has a different fee and covers prescription drugs in a different way. To figure out which plan is best for you, you should make a list of the prescription drugs you take and compare it to the formularies of each plan.
Depending on the plan you choose and the medicines you need, SilverScript’s Medicare Part D plans offer a range of fees and copays that can fit almost any budget. Also, these plans cover you at thousands of pharmacies across the country. Even though the SilverScript formulary changes every year, this provider’s prescription drug plans offer full coverage and reasonable prices.
A formulary is a list of all the prescription drugs that a certain insurance will pay for. When looking for coverage for your prescription drugs, you should know what drugs you take and how the Medicare Part D plans in your area cover them. So, you can sign up for a plan that will cover your medicines. There are times when a Medicare Part D plan might not cover the medicine you need. There could be a formulaic option, though. Your doctor may think about a change if they think it would be a good idea. If not, you could ask for a list exception, which means that the plan may cover your drug if it is approved.
SilverScript may change its formularies from time to time, so it’s important to check your prescription drug benefits every year during the Annual Enrollment Period. This will make sure that you get the right coverage every year. There are five tiers of drugs, and each tier may have its own fees or copayments for coverage. Here’s how the tiers are broken up:
Tier 2 – Generic drugs that usually cost more than tier 1 drugs
Tier 3 – Preferred brand-name drugs with no generic version
Tier 4 – Less commonly prescribed non-preferred drugs
Tier 5 – Expensive specialty drugs that may require monitoring
In the formulary you will also see information about any restrictions or terms for coverage that apply to each drug. These rules are listed at the beginning of the formulary. They can include things like needing Aetna’s authorization first or limits on how many drugs can be covered at once. There’s a chance that a SilverScript formulary might be a little different based on where the plan is sold.
SilverScript Plans
There are three different SilverScript coverage choices for Medicare beneficiaries:
SilverScript SmartSaver
This choice is for people who are active, prefer generic drugs, and are generally healthy. It has the lowest national average of monthly premiums at $5.92. It includes $0 deductibles for Tier 1 drugs, and $505 deductible for Tiers 2-5. The copays for preferred pharmacies by tier are:
Tier 1 – $2 copay for 30-day prescriptions and $6 for 90-day prescriptions
Tier 2 – $15 for 30-days’ worth and $45 for 90-days
Tier 3 – 25% coinsurance
Tier 4 – 50% coinsurance
Tier 5 – 25% coinsurance for 30-day prescriptions
SilverScript Choice
This plan covers more than the SmartSaver plan, but it has a $505 deductible and a $33.60 monthly premium. If you qualify for the Extra Help program, you can get a $0 monthly premium instead. The copays for preferred pharmacies are:
Tier 1 – $2 copay for 30-day prescriptions and $6 for 90-day prescriptions
Tier 2 – $7 for 30-days’ worth and $21 for 90-days
Tier 3 – 17% coinsurance for a 30-day supply; 22% for 90
Tier 4 – 30%-40% coinsurance
Tier 5 – 25% coinsurance for 30-day prescriptions
SilverScript Plus
This plan has even better coverage than the first 2, with a $75.58 monthly fee, a $0 deductible on all tiers, and a coverage gap for Tier 1 and 2 drugs. I also has$0 copays on Tier 1 and 2 drugs for the other tiers the copays are:
Tier 3 – $47 copay for a 30 day supply; $141 for 90
Tier 4 – 50%-40% coinsurance for both supply amounts
Tier 5 – 33% coinsurance for 30-day prescriptions
What Pharmacies Accept SilverScript?
SilverScript lets you get your prescription drugs from thousands of pharmacies across the country. There are more than 65,000 pharmacies in the United States that are part of the SilverScript drugstore network. Your SilverScript Medicare Part D plan will be accepted at most chain pharmacies. But not all shops are in the “preferred category”. With a preferred pharmacy, you can get the drugs for the least amount of money. These pharmacies include:
Walmart
CVS
Wegmans
Kroger
Publix
Even though they cost a little more than preferred pharmacies, standard network pharmacies still offer service. These pharmacies include:
Walgreens (for most SilverScript plans)
Sam’s Club
There are also many local pharmacies that fall into either of those categories so be sure to check your plan for your area’s local pharmacies.
How To Choose
There are a few things to think about when choosing the right Part D plan, whether it’s SilverScript or any other plan, for you. The major things you should think about are cost, coverage, and how flexible the plan is. Cost is always a factor when choosing a Part D plan. Different plans come with different costs. Coverage gaps, fees, deductibles, copayments or coinsurance, and premiums all affect your overall cost. If you are in good health and prefer to take generic drugs, you may want to choose a plan with a lower premium and benefits for tier 1 or tier 2 drugs. You can choose a plan with a higher cost and more benefits to help with your health care needs if you need specific drugs, have serious health problems, or need more specific coverage.
You also need to know how much coverage you need. If you don’t need a lot of coverage, you may want to save money by getting a plan with less coverage. But if you need more coverage because of your health or for your own peace of mind, you may want to look into plans with more coverage that cost more. Choosing the best Part D plan will also depend on how flexible you are about the drugs and pharmacies you want to use. If you don’t mind taking generic or recommended generic drugs, you may have more plan choices. Also, if you are willing to get your drugs from different pharmacies you will have more plans to choose from. However, if you have specific drug plans or pharmacies in mind, you may need to look at better coverage plans to see what works best for you.
Call EZ
If you want to compare SilverScript drug plans, you should think about the prescription drugs you take and how much of them you take. You should also think about how much you are willing to pay for premiums and a yearly deductible. As we’ve already said, if the cost of your medicines is getting too high for you, a SilverScript plan could help you by putting all of your monthly costs into one payment.
You should also look into a Medicare Supplement Plan if you want to save even more money. There are 10 Medicare Supplement Plans to choose from, and each one has different rates and coverage choices. Talk to an EZ agent about all of your choices. The agents at EZ work with the best insurance companies in the country, and they can review plans for you for free in just a few minutes. Enter your zip code in the box below to get free instant quotes for plans that cover your present doctors, or call 877-670-3602 to talk to a licensed agent.
This year, Medicare Part B premiums rates are not the only rates on the rise. The Centers for Medicare and Medicaid (CMS) released the 2021 Medicare Part D rates back in October, and noted that, while there are more Part D plans being offered in 2021, plan rates have gone up slightly. Because prices for Medicare Parts A, B, and D continue to rise, there is no better time than now to look into Medicare Supplement Plans.
Part D Plans & Prices
The average Medicare beneficiary has a choice of almost 30 Medicare stand-alone drug plans. The following charts illustrate the costs of Part D plans and how income affects rates.
Medicare Part D RatesMedicare Part D Income Rates
Part D Cost-Sharing
Cost-sharing amounts have also changed for medications in certain “tiers” in Part D plans. Each plan has a drug formulary, made up of tiers which determine the price of each drug. The typical five-tier formulary structure places medications into the following categories:
Preferred generics
Generics
Preferred brands
Non-preferred drugs
Specialty drugs
For all Part D Plans, the median standard cost sharing in 2021 is $0 for preferred generics, $5 for generics (up from $4 in 2020), $40 for preferred brands (down from $42 in 2020), 40% coinsurance for non-preferred drugs (up from 38% in 2020; the maximum allowed is 50%), and 25% coinsurance for specialty drugs (the same as in 2020; the maximum allowed is 33%).
Medicare Supplement Plans
Costs continue to increase yearly for Medicare beneficiaries, but that does not mean you have to live on a tight budget. Medicare Supplement Plans can help you pay for medical costs that Original Medicare does not cover. For example, Medicare Supplement Plans cover the 20% coinsurance that you usually pay for a medical service. There are 10 different types of Medicare Supplement Plans to choose, and each offers different coverage at different price points. To easily compare these plans within minutes, use an EZ agent. Our agents will compare prices, go over your financial and medical needs, and help you save hundreds a year – and we’ll do it all for free! Medicare rates are on the rise, but we will help you save! To get started, simply enter your zip code in the bar above, or to speak directly to a licensed agent, call 888-753-7207.
