SilverScript covers both brand name drugs and generic drugs. A generic drug is approved by the FDA as having the same active ingredient as the brand name drug. Generally, generic drugs cost less than brand name drugs. 08/28/2021 III
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Is a silverscript drug plan right for You?
When shopping for Medicare Part D plans, you may find yourself interested in a SilverScript drug plan. SilverScript is a Part D prescription program that offers drug plans approved by Medicare to provide Part D coverage. These drug plans are a popular choice for many seniors because they offer low premiums and comprehensive coverage.
Does silverscript Medicare Part D cover prescriptions?
SilverScript Medicare Part D prescription drug plans are available nationwide. Members have access to more than 65,000 pharmacies across the United States. SilverScript offers three Medicare Part D plan options in 2021. If you have Medicare Part A and Part B, you may be looking for additional coverage for prescription drugs.
How many people are members of the silverscript drug program?
More than 5 million people are members of the SilverScript family. Many benefits come with this drug program, and we’ll take a look at those benefits below. SilverScript offers three different Part D plans; the SmartRx, Choice, and the Plus plan.
Does Medicare cover sildenafil?
However, Part D does cover some generic versions, such as Sildenafil. You’ll need to take a close look at your plans’ drug formularyto see if the generic version is included and how much it will cost out of pocket. Some MAPD plans cover both Viagra and the generic versions. The drug class is a PDE-5 inhibitor. Does Medicare Cover Cialis?
Does SilverScript cover Tier 3 drugs?
SilverScript Choice also includes delivering your Tier 1, 2, and 3 prescriptions.
Is SilverScript Smart Rx a good Part D plan?
All of Aetna's PDPs have a Medicare star quality rating of 3.5 out of five stars. CVS/Aetna's SilverScript Smart RX plan has the lowest average monthly premium in 2022, and CVS is one of four main providers of stand-alone Part D prescription drug plans in the United States.
How do you find out what drugs are covered by Medicare?
Get information about specific drug plans and health plans with drug coverage in your area by visiting Medicare.gov/plan-compare or by calling 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.
What Pharmacy Can I use with SilverScript?
SilverScript's nationwide pharmacy network includes more than 67,000 locations that will accept your coverage, including CVS Pharmacy®, Walgreens®, Walmart®, Sam's Club®, thousands of regional, independent and grocery store pharmacies and CVS Caremark Mail Service Pharmacy.
What is the difference between SilverScript choice and SilverScript Smart Rx?
The SilverScript Plus plan has no deductible and more coverage during the Part D donut hole, while the SilverScript Choice and SilverScript SmartRx plans offer lower monthly premiums.
Which SilverScript plan is the best?
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.
What are two options for Medicare consumers to get Part D prescription drug coverage assuming they meet all eligibility requirements )? Select 2?
There is no other way a Medicare consumer could get Part D prescription drug coverage. They could enroll in a Medicare Supplement Insurance Plan. They could enroll in a Medicare Advantage Plan or other Medicare health plan that includes prescription drug coverage.
What drugs does Medicare Part B pay for?
Drugs that are covered by Medicare Part B include the following.Certain Vaccines. ... Drugs That Are Used With Durable Medical Equipment. ... Certain Antigens. ... Injectable Osteoporosis Drugs. ... Erythropoiesis-Stimulating Agents. ... Oral Drugs for ESRD. ... Blood Clotting Factors. ... Immunosuppressive Drugs.More items...•
What will Medicare not pay for?
In general, Original Medicare does not cover: Long-term care (such as extended nursing home stays or custodial care) Hearing aids. Most vision care, notably eyeglasses and contacts. Most dental care, notably dentures.
What is the deductible for SilverScript Part D?
Compare our plansSilverScript SmartRx (PDP)Deductible††Tier 1: $0Tier 1 copay**$1Tier 2 copay**$19Cost of 90-day supply of prescription medication §§Tier 1: $32 more rows•Jan 6, 2022
Does SilverScript Part D cover shingles shot?
Aetna Medicare and SilverScript Part D plans cover the shingles vaccine and some commercially available vaccines. Part D in general covers recommended adult immunizations when needed to prevent illness.
What is the monthly cost of SilverScript?
SilverScript Plus offers monthly premiums that average $69.52 per month, but the plan includes a $0 deductible for all drug tiers, a $0 copayment for Tier 1 drugs and $2 copayments for Tier 2 drugs.
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 many pharmacies are covered by SilverScript Part D?
SilverScript Part D plans have many coverage benefits, including: lower copays at more than 18,500 pharmacies for SilverScript SmartRx and 23,000-plus pharmacies for SilverScript Choice and SilverScript Plus.
What is SilverScript SmartRx?
The SilverScript SmartRx plan is intended for active, generally healthy adults who take generic maintenance drugs or no regular medications. Its formulary offers a substantial list of tier 1 drugs at a $0 copay at preferred pharmacies during the initial coverage phase.
How much is tier 1 coinsurance?
Tier 1: $0 at preferred pharmacies and mail-order service; $5 to $15 at nonpreferred pharmacies. Tier 2: $0 to $2 at preferred pharmacies and mail-order service; $10 to $30 at nonpreferred pharmacies. Tier 3: $47 to $141 range for all pharmacies and supply amounts. Tier 4: 50 percent coinsurance.
How much is SilverScript Plus?
SilverScript Plus: $52.20 to $88.60. These rates vary depending on where you live. You can enter your specific ZIP code to search for prices using Medicare’s plan finder tool. As with all Part D plans, the premium for your SilverScript plan is in addition to the other costs you pay for Medicare.
Does SilverScript have Medicare?
SilverScript offers prescription drug coverage through three different Medicare Part D plans. Here’s an overview of each option — we’ll dive deeper into price details later in the article.
Is SilverScript part of Aetna?
SilverScript is one of the largest providers offering Medicare Part D coverage in the United States, with plans in all 50 states. It became part of Aetna Medicare for the 2021 health plan year. SilverScript offers three different plans this year, including one with a $0 deductible on all covered drugs. Members have access to a large network of more ...
Does SilverScript Plus have a deductible?
With SilverScript, you have access to more than 65,000 pharmacies, as well as many preferred pharmacies. The SilverScript Plus plan has no deductible and more coverage during the Part D donut hole, while the SilverScript Choice and SilverScript SmartRx plans offer lower monthly premiums.
What is an outpatient hospital?
hospital outpatient setting. A part of a hospital where you get outpatient services, like an emergency department, observation unit, surgery center, or pain clinic. . Here are some examples of drugs Part B covers: Drugs used with an item of durable medical equipment (DME) : Medicare covers drugs infused through DME, ...
What is Part B in medical?
Prescription drugs (outpatient) Part B covers certain doctors' services, outpatient care, medical supplies, and preventive services. covers a limited number of outpatient prescription drugs under limited conditions. A part of a hospital where you get outpatient services, like an emergency department, observation unit, surgery center, or pain clinic.
What is a prodrug?
A prodrug is an oral form of a drug that, when ingested, breaks down into the same active ingredient found in the injectable drug. As new oral cancer drugs become available, Part B may cover them. If Part B doesn’t cover them, Part D does.
What happens if you get a drug that Part B doesn't cover?
If you get drugs that Part B doesn’t cover in a hospital outpatient setting, you pay 100% for the drugs, unless you have Medicare drug coverage (Part D) or other drug coverage. In that case, what you pay depends on whether your drug plan covers the drug, and whether the hospital is in your plan’s network. Contact your plan to find out ...
What is formulary in insurance?
If you have drug coverage, check your plan's. formulary. A list of prescription drugs covered by a prescription drug plan or another insurance plan offering pre scription drug benefits. Also called a drug list. to see what outpatient drugs it covers. Return to search results.
How long does Medicare cover ESRD?
If you're entitled to Medicare only because of ESRD, your Medicare coverage ends 36 months after the month of the kidney transplant.
What is end stage renal disease?
End-Stage Renal Disease (Esrd) Permanent kidney failure that requires a regular course of dialysis or a kidney transplant. or you need this drug to treat anemia related to certain other conditions. Blood clotting factors: Medicare helps pay for clotting factors you give yourself by injection, if you have hemophilia.
What to do if SilverScript Choice doesn't cover my drug?
If your drug is not included in this formulary (list of covered drugs), you should first contact Customer Care and ask if your drug is covered. If you learn that SilverScript Choice (PDP) not cover your drug, you have two options: •You can ask Customer Care for a list of similar drugs that are covered by our plan. When you receive the list, show it to your doctor and ask him or her to prescribe a similar drug that is covered by our plan. •You can ask us to make an exception and cover your drug. See below for information about how to request an exception.
How many tablets does SilverScript cover?
For certain drugs, SilverScript Choice (PDP) limits the amount of the drug that we will cover. For example, our plan provides up to 30 tablets per prescription for doxazosin. This may be in addition to a standard one-month or three-month
What is SilverScript Choice?
SilverScript Choice (PDP) covers both brand name drugs and generic drugs. A generic drug is approved by the FDA as having the same active ingredient as the brand name drug. Generally, generic drugs cost less than brand name drugs.
How to contact SilverScript?
This formulary was updated on August 1, 2016. For more recent information or other questions, please contact SilverScript at 1-866-235-5660 or, for TTY users, 711, 24 hours a day, 7 days a week, or visit
What does "we" mean in the drug list?
When this drug list (formulary) refers to “we,” “us ,” or “our,” it means SilverScript
Where is the formulary for drugs?
The formulary begins on page 7. The drugs in this formulary are grouped into categories depending on the type of medical conditions that they are used to treat. For example, drugs used to treat a heart condition are listed under the category, “Cardiovascular”. If you know what your drug is used for, look for the category name in the list that begins on page 7. Then look under the category name for your drug. 1
Does SilverScript cover drug A?
For example, if Drug A and Drug B both treat your medical condition, we may not cover Drug B unless you try Drug A first. If Drug A does not work for you, we will then cover Drug B. You can find out if your drug has any additional requirements or limits by looking in the formulary that begins on page You can also get more information about the restrictions applied to specific covered drugs by visiting our webWe site. have posted on line documents that explain our prior authorization and step therapy restrictions. You may also ask us to send you a copy. Our contact information, along with the date we last updated the formulary, appears on the front and back cover pages. You can ask us to make an exception to these restrictions or limits or for a list of other, similar drugs that may treat your health condition. See the section, “How do I request an exception to the SilverScript formulary?” on page 3 for information about how to request an exception.
Check our drug list
Search our formulary for covered drugs and get the information you need. It shows the drugs we cover, the tier a drug is on, any limits or requirements and mail order availability. Generally, the lower the tier, the less you pay. Your Summary of Benefits tells you the drug costs for tiers.
Get our full drug list and more
See a complete list of our covered drugs and other important prescription drug information.
Find a drug by name
Search for a specific drug by name and see if generic equivalents are available. Enter your ZIP code to get started.
Does Medicare Cover Viagra?
The retail cost of Viagra can be very expensive. Part D plans do not cover Viagra. However, Part D does cover some generic versions, such as Sildenafil.
How much does Part B cover?
Generally, this is an outpatient service, so Part B covers 80% of the allowable costs. The beneficiary is responsible for the remaining 20%. Part B also includes penile pumps and other devices like it.
Is Levitra covered by Part D?
Levitra is not covered under Part D. There are a few generic versions that do have coverage. Some MAPDs cover Levitra, as well as the generic version. However, you’ll have less out of pocket costs if you go with the generic version. Again, the drug class is a PDE-5 inhibitor.
Who is Lindsay Malzone?
Lindsay Malzone is the Medicare expert for MedicareFAQ. She has been working in the Medicare industry since 2017. She is featured in many publications as well as writes regularly for other expert columns regarding Medicare.
Does Medicare cover erectile dysfunction?
Medicare coverage for erectile dysfunction prescriptions may have coverage under Part D. Most brand name medications for erectile dysfunction, such as Viagra, Cialis, and Levitra, are not covered under Part D. However, the generic versions have some coverage.
