Medicare Blog

how does medicare silverscript work

by Michele Brown Published 2 years ago Updated 1 year ago
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How does SilverScript Work If you are enrolled in the Original Medicare Parts A and B, you will need a separate Part D prescription drug plan if you want your prescription drug coverage. SilverScript offers two plans: SilverScript Choice and SilverScript Plus to meet this requirement.

SilverScript Choice is a basic plan that offers comprehensive coverage. Enrolled beneficiaries can benefit from a $0-deductible on all covered drugs in most states and $0-copays for 90-day supplies of Tier 1 drugs nationwide when filled through the CVS Caremark Mail Service Pharmacy.Oct 1, 2018

Full Answer

What is a silverscript preferred pharmacy?

SilverScript has a network of preferred pharmacies with over 23,000 network pharmacies. The preferred pharmacies tend to have lower coinsurances and copayments. CVS, Publix, Walmart, and Kroger are a few of the preferred pharmacies available. Many times, people may like to use mail order pharmacy services.

Does Walgreens accept silverscript insurance?

You’ll find most of your big-name pharmacies will accept your insurance. Walmart, CVS, Wegmans, and Walgreens are a few of the most popular pharmacy choices. Many local pharmacies also accept SilverScript coverage. SilverScript has a network of preferred pharmacies with over 23,000 network pharmacies.

What is silverscript choice PDP?

SilverScript Choice (PDP) is a Basic Alternative 2021 Medicare (Part-D) Prescription Plan by Aetna Medicare. Stand-alone plans offer additional prescription drug coverage only and are an option if you are on Original Medicare insurance or you have a Medicare health plan that does not include Part D coverage.

What is silver script coverage?

SilverScript has a total of five tiers:

  • Preferred Generics: Tier 1 has the lowest costs for preferred generic medications. ...
  • Generic: Copays for level 2 medications can range from $1-2.
  • Preferred Brand Prescriptions: Both non-preferred generics and preferred brand drugs.
  • Non-Preferred Drug: Non-preferred generics and non-preferred brand name drugs.

More items...

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Is SilverScript a good prescription plan?

Fortunately, the SilverScript SmartRx plan has very low copays on the most common prescriptions. It won't be the best fit for everyone, but it can be a good choice for those on only Tier I generics. The Choice or Plus plan can also be a good fit if you're taking more expensive medications.

What is the monthly cost of SilverScript?

Compare our plansSilverScript SmartRx (PDP)SilverScript Choice (PDP)Average monthly premium$7.08$30.78†Deductible††Tier 1: $0Tier 1 / Tier 2: $0Tier 1 copay**$1$0Tier 2 copay**$19$5§2 more rows•Jan 6, 2022

What is the deductible for SilverScript?

SilverScript Choice: $0 deductible for tier 1 and tier 2 drugs and a deductible from $205 to $445 for tiers 3 to 5. SilverScript Plus: $0 deductible on all covered drugs.

What carrier is SilverScript?

SilverScript is now part of Aetna Medicare Pay your premium.

What is the best SilverScript plan?

The strongest coverage is available with the SilverScript Plus plan, which has a $0 deductible across all drug tiers and additional gap coverage. A key advantage of these plans is that members get access to the digital tools of CVS Caremark.

Does SilverScript pay for the shingles shot?

Aetna Medicare and SilverScript Part D plans cover the shingles vaccine and some commercially available vaccines.

What is the copay for SilverScript?

SilverScript SmartRX (PDP) Tier 2 drugs come with a $19 copayment. According to the Kaiser Family Foundation, the SilverScriptRx plan has the lowest monthly premium of all Part D plans in the country for 2021.

Does CVS own SilverScript?

Since 2006, CVS has sold its individual PDPs through a wholly-owned subsidiary called SilverScript Insurance Company.

Is SilverScript only good at CVS?

SilverScript Preferred Pharmacies Walmart, CVS, Wegmans, Kroger, and Publix are a few of the most popular pharmacy choices. However, many local and independent pharmacies also accept SilverScript coverage.

Is SilverScript owned by CVS or Aetna?

SilverScript is a Medicare Prescription Drug Plan (PDP) owned by CVS Health. As Aetna is also owned by CVS Health, we are integrating our plans with SilverScript.

SilverScript Part D Drug Plans

SilverScript offers three different Part D plans; the SmartRx, Choice, and the Plus plan.

SilverScript Formulary for 2022

You’ll want to be aware of covered medications when you begin shopping for drug plans. Once released, you’ll find the updated formulary for 2022 in the SilverScripts document library.

How to Enroll in SilverScript

When you're ready to sign up for SilverScript, you'll be able to do so with ease. Make sure to have your Medicare I.D. card with you. You can apply online in a matter of minutes.

How much does SilverScript cost?

SilverScript Choice (PDP) Enrollees in SilverScript Choice will need to pay between $215 and $435 (the maximum deductible allowed by Medicare 3) before SilverScript covers drug costs. However, this deductible applies only to brand name and specialty drugs—Tier 3 through Tier 5.

What is Medicare Part D?

Is SilverScript Medicare Part D? Medicare Part D is the part of Medicare that covers prescription drugs. Medicare regulates Part D, but private companies sell the Part D plans themselves. SilverScript is one of those private companies that sells two Medicare Part D plans: SilverScript Choice and SilverScript Plus.

Does SilverScript have a deductible?

Seekers of low (or no) deductibles: One of SilverScript’s plans doesn’t require a deductible before drug coverage begins, and the other plan has a $0 deductible on Tier 1 and Tier 2 generics. Those who prefer home delivery: CVS Caremark delivers medications to your home for the same price as you’d pay in person at a preferred pharmacy.

Does SilverScript have a Medicare Part D plan?

SilverScript Part D prescription drug plans. SilverScript does one thing and one thing only: Part D. For such a large provider, it may be surprising that it offers just two plan options for Medicare recipients. But this lack of options can make deciding between two plans easier if you already know you prefer SilverScript.

Does SilverScript work with CVS?

You may be even more on board if you're a fan of CVS or Walmart—or at least live close to one—as SilverScript counts both businesses as preferred pharmacies. People who have trouble getting around may enjoy CVS's mail-order pharmacy, Caremark, which delivers meds to your door for the same price you’d pay in-store.

Is SilverScript Choice a good plan?

The Choice plan boasts lower premiums than the Plus plan, so if you want low monthly costs and primarily take generic medications, SilverScript Choice may be a good fit for you. However, you can’t know for sure what this plan will cost until you compare the medications you take with the plan’s formulary.

Do you have to meet a deductible for generics?

However, this deductible applies only to brand name and specialty drugs—Tier 3 through Tier 5. If you rely mostly on generic medications (Tier 1 or Tier 2), you won’t need to meet a deductible before your drug coverage begins.

SilverScript Part D Plans

There are three different Medicare Part D Plans offered by SilverScript:

SilverScript Part D Benefits

The SilverScript drug plan offers a variety of benefits that differs between plans. In general, the benefits include:

How Much Does a SilverScript Drug Plan Cost?

The cost for a SilverScript drug plan can vary depending on the area or region you live in. The standard annual deductible threshold for Part D plans in 2021 is $445, so you can expect to pay no more than that for your yearly Part D plan deductible. SilverScript drug plans also typically have low or even $0 copays for tier 1 drugs.

How to Choose a Part D Plan?

There is no one-size-fits-all when it comes to prescription drug coverage. While one plan may work for a friend or family member, it may not be the best choice for you. Each individual has their own specific needs when it comes to prescription coverage, which is why it is important to compare multiple plans before enrolling in a Part D drug plan.

SilverScript Enrollment Period

Avoid a costly late enrollment penalty by enrolling in a SilverScript drug plan or Part D drug plan when you are first eligible. The first opportunity you have to enroll is during your Initial Enrollment Period (IEP).

How does Original Medicare work?

Original Medicare covers most, but not all of the costs for approved health care services and supplies. After you meet your deductible, you pay your share of costs for services and supplies as you get them.

How does Medicare Advantage work?

Medicare Advantage bundles your Part A, Part B, and usually Part D coverage into one plan. Plans may offer some extra benefits that Original Medicare doesn’t cover — like vision, hearing, and dental services.

How does SilverScript work?

How Does It Work? According to their website, SilverScript was established in 2006 as an insurer chosen to help launch the Medicare Part D program and has since grown to become America’s largest stand-alone Medicare Part D insurer .

What is SilverScript.com?

SilverScript.com is the online home of SilverScript, a subsidiary of CVS Health which claims that they are “dedicated to improving quality of life for all Americans” with their Medicare Part D prescription plans.

How many times does a supervisor read a member's web page?

You can go up the ladder to supervisor (only after an hour on the phone with a first level representative) and the supervisor will read your member web page to you three or four times . What she reads will not match the page you log into.

Does SilverScript have a stand alone plan?

SilverScript says that they offer their customers a choice of two stand-alone prescription drug plans that are designed for people who simply need coverage for a few prescription medications throughout the year, as well as those who need several medications to treat chronic conditions.

Does Medicare Part D include a prescription?

There are many different insurance plans which work as additional Medicare coverage and include a Part D prescription plan, so customers who feel that this plan is not right for them will have other options in their state of residence.

How much does SilverScript Plus cost?

Unlike the first two, it has no deductible you need to meet. In most areas, it will cost near $70 a month. It will also offer $0 copays on Tier I & II prescriptions and may offer the lowest copays on more expensive, brand name pharmaceuticals.

How many pharmacies does SmartRx have?

The SmartRx PDP will have a smaller network of approximately 18,500 preferred pharmacies. Many on this list above will be included. If you’re flexible on where you shop, then you’ll save overall. It’s just a matter of staying in network and using a preferred pharmacy.

Is SilverScript a Medicare supplement?

It’s important to know there are no Medicare supplement plans sold today offering prescription Part D insurance plans. SilverScript can be a good fit for those looking for a low cost Medicare drug plan with a large nationwide network of pharmacies to pair with their Medigap policy. Contact us today to learn more.

Does SilverScript have a low copay?

In other words, it doesn’t matter if the premiums are low if the copays are very high. Fortunately, the SilverScript SmartRx plan has very low copays on the most common prescriptions. It won’t be the best fit for everyone, but it can be a good choice for those on only Tier I generics.

Can you get Medicare Part D at a pharmacy?

With some Medicare Part D providers, you can only get the lowest prices at a small handful of pharmacies. That’s not the case with SilverScript which has several options, both large and small. This is helpful for those living in rural areas and those who spend significant time in more than one state.

Can you compare SilverScript insurance?

It is wise to compare your options before enrolling in new coverage, however. There may be a policy with another company that is better for you overall. You can click on the green “Compare Plans Now” button on the right to view SilverScript and many other plans side by side.

Is Aetna SilverScript Part D?

If you’re on Medicare, you may be interested in an Aetna SilverScript Part D prescription drug plan. For 2021, their SmartRx plan offers some of the lowest premiums in the country. This will be a great option for those on a few generics or no prescriptions at all. All three of the Aetna plans for 2021 are competitively priced while offering ...

What is a nonprescription drug?

Drugs given in hospitals or doctors’ offices that are already covered under Part A or Part B. Any drugs not listed on a plan’s drug formulary (except in special circumstances) Nonprescription drugs or prescription vitamins (other than prenatal vitamins).

How many stages of Medicare Part D coverage?

There are four stages of Medicare Part D coverage that may change what you pay for covered prescriptions (aside from your plan premium) over the course of a year. The annual deductible stage - You begin in the annual deductible stage (if your plan has a deductible).

What is MAPD insurance?

A Medicare Advantage prescription drug plan ( or MAPD) is a plan — from a private insurer such as Aetna — that combines all your health coverage into one plan. A MAPD plan includes: Medicare Part A (hospital) Medicare Part B (medical) Medicare Part D (prescription) Like other health plans, MAPDs come in various forms, ...

What happens when you are in the coverage gap?

When you’re in the coverage gap, you will pay no more than 25% of the cost for your plan's covered brand-name or generic prescription drugs. The coverage gap ends when you have spent enough to qualify for catastrophic coverage. Some people will never enter the coverage gap because their drug costs won’t be high enough.

Do prescriptions apply to deductible?

Keep in mind, some prescriptions may not apply to the deductible. The initial coverage stage - This is the stage after you have met your deductible (if it applies) and before your total drug costs have reached the initial coverage limit. Total drug costs include what you have paid and what your plan has paid.

Can you get Medicare Part D through a PDP?

You can get Part D coverage through a stand-alone prescription drug plan (commonly referred to as a PDP) or some Medicare Advantage plans (commonly referred to as a MAPD or Part C). What is a prescription drug plan (PDP)? A prescription drug plan (PDP) is a stand-alone Medicare Part D plan. PDPs only offer Part D and work together ...

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