Article at a glance
Prescription Drug Plans (PDP), or Medicare Part D, are plans that provide drug coverage alongside Medicare and Medicare Advantage Plans.
SilverScript is an insurance provider with plans available in all 50 states. SilverScript joined Aetna Medicarein2021.
There are different types of PDP plans that vary in coverage, providers, andcost.
SilverScript provides arange of PDPs that include unique benefits including low premiums, coverage for Tier 1drugs, and certain types of insulincoverage.
When it comes to Medicare, there are multiple options to choose from. Medicare is afederal government program that provides healthcare coverage for those ages 65 and older, younger Americans with disabilities, or those with end-stage renal disease (ESRD). It comes in different sections, known as Medicare Parts, that cover aspects such as hospital insurance and drugcoverage.
The Medicare part that covers medication is known as Medicare Part D. When looking at Part Dplans, there are quite afew companies that provide coverage to ensure you receive your necessary prescriptions. Today, we’re looking at the insurance company SilverScript, which specializes in Part Dprescription drugplans.
What Is MedicarePartD?
Medicare Part Dis Medicare’s prescription drug plan. These drug plans help cover aportion of aMedicare beneficiary’s medications. Medication costs can add up quickly and lead to large out-of-pocket costs without insurance. Medicare Part Dplans help to shoulder the prescription drug costs so beneficiaries can get the medications theyneed.
Medicare is broken into different sections, or parts, each one designed to cover specific healthcare services. The parts of Original Medicareare:
Medicare Part A (hospital insurance)
Medicare Part B (medical insurance)
Neither of these options covers prescription drugs. Alternatively, there are Medicare Advantage Plans (known as Medicare Part C), offered through aprivate insurance company, that may include Part Dcoverage, but this isn’t the case for all Medicare Advantage Plans.
If Original Medicare enrollees or those with aMedicare Advantage Plan without an existing Part Dplan want prescription medication coverage, they’d need to enroll in aseparate Medicare Part Dplan, such as SilverScript.
What Is SilverScript?
SilverScript is one of the largest providers in the United States of Medicare Part Dprescription drug coverage plans. SilverScript Medicare Part Dplans are available in all 50 states (with the exception of the SilverScript Plus plan, which is unavailable in Alaska), and they offer three different plan options. In 2021, they joined AetnaMedicare.
Types of SilverScript Part DPrescription Drug Plans (PDP)
The types of SilverScript Medicare Part Dplans include SilverScript SmartSaver PDP, SilverScript Choice PDP, and SilverScript PlusPDP.
SilverScript SmartSaver PDP
This option is geared toward active adults who prefer generic drugs and are fairly healthy overall. It includes monthly premiums of $5.92, $0 annual deductibles, $2 copays for Tier 1drugs ($0 copay at preferred pharmacies during the initial coverage phase),andmore.
SilverScript ChoicePDP
This plan provides more coverage than the SmartSaver plan, but does have a $505 deductible and $33.60 monthly premium (though if aperson qualifies for the Extra Help program, they can receive a $0 monthlypremium).
SilverScript PlusPDP
This plan includes even greater coverage, with a $75.58 monthly premium, a $0 deductible on all tiers, as well as $0 copays on Tier 1and 2drugs, as well as acoverage gap for Tier 1and Tier2drugs.
Note: for more information about SilverScript plans, visit thissource.
Costs For SilverScript Plans
When talking about costs for Part Dplans, there are different costs associated with different parts, depending on the plan selected. These costs include deductibles, copays and coinsurance, andpremiums.
Deductibles
Deductibles are the amount of money aperson must pay before their health insurance kicks in. The different deductibles for each SilverScript plan are asfollowed:
SilverScript SmartSaver: $0 deductible for Tier 1, $505 for Tiers 2–5
SilverScript Choice: $505 deductible for alltiers
SilverScript Plus: $0 deductible on alltiers
Copays and Coinsurance
Copays are fixed amounts that you pay for services after the deductible is met. Coinsurance is the percentage of health costs you pay after the deductible has been met. The copays and coinsurance for each SilverScript plan and tierinclude:
SilverScript SmartSaver
Tier 1: $2 copay for 30-day and $6 copay for 90-day supply at preferred pharmacies
Tier 2: $15 copay for 30-day and $45 for 90-day at preferred pharmacies
Tier 3: 25% coinsurance for 30-day or 90day at preferred pharmacies
Tier 4: 50% coinsurance on 30-day or 90-day at preferred pharmacies
Tier 5: 25% coinsurance for 30-day at preferred pharmacies
SilverScript Choice
Tier 1: $2 copay for 30-day supply and $6 copay for 90-day supply at preferred pharmacies
Tier 2: $7 copay for 30-day or $21 copay for 90-day at preferred pharmacies
Tier 3: 17% coinsurance for 30-day or 22% coinsurance for 90-day at preferred pharmacies
Tier 4: 30%-40% coinsurance at preferred pharmacies
Tier 5: 25% coinsurance for 30-day at preferred pharmacies
SilverScript Plus
Tier 1: $0 copay for 30 or 90-day supply at preferred pharmacies
Tier 2: $0 copay for 30 or 90-day at preferred pharmacies
Tier 3: $47 copay for 30-day or $141 copay for 90day at preferred pharmacies
Tier 4: 50% coinsurance for 30 or90-day
Tier 5: 33% coinsurance for30-day
Premiums
Premiums are monthly fees that pay for insurance coverage. Premiums for each SilverScript planare:
SilverScript SmartSaver: $5.92/month
SilverScript Choice: $33.60/month
SilverScript Plus: $75.58/month
SilverScript Additional Benefits
SilverScript drugs plans include multiple coverage benefits, including:
$0 copays for preferred genericdrugs
Access to anetwork of more than 65,000 pharmacies, including thousands of preferred pharmacies with additional discounts
Potential $0 deductible for all covereddrugs
As low as $1 copay on Tier 1drugs when filled at apreferred retailpharmacy
Savings on certain insulins at apreferred pharmacy (only with certainplans)
Lower copays at 18,500+ pharmacies for SilverScript SmartSaver and 23,000+ pharmacies for SilverScript Choice and SilverScript Plus
Cost savings for 90-day mail-order refills
Formularies with tiers that cover that majority of Medicare-prescribed drugs
How To Choose The Best Part DPrescription DrugPlan
When deciding on which Part DPDP option is right for you, there are afew things toconsider.
Cost
When selecting aPart Dplan, costs are always afactor in the decision-making process. There are varying costs that come with plans, including:
Monthly premiums
Copayments and coinsurance
Deductibles
Coverage gap
If you are aperson who is in great health and prefers to take generic drugs, you may opt for aplan with alower premium and coverage for tier 1or tier 2drug options. If you have specific drugs you are prescribed, have significant health conditions, or need more definitive coverage, you may choose aplan with ahigher premium and more benefits to help with your healthcare needs.
Coverage
Similar to cost, the amount of coverage needed is necessary to make an informed decision. If you don’t need alarge amount of coverage, you may prefer choosing aplan with less coverage to save money. However, if you require greater coverage—whether due to health conditions or for your peace of mind—you will want to consider plans that have larger coverage at ahigher cost.
Flexibility
The flexibility you have towards the types of drugs and pharmacies you want to use will also play apart in choosing the best Part Dplan. If you are okay with taking preferred generic or generic drugs, then you may have more plan options to select from. Additionally, if you are open to different pharmacies or retail pharmacy providers to get your drugs, then more plans will be available. However, if you have specific drug plans or pharmacies in mind, you may need to look at higher coverage plans to see what works bestforyou.
Who Owns SilverScript?
SilverScript partnered with Aetna in 2021 for fuller Medicare coverage, but Aetna (and therefore SilverScript) are owned by CVS Health.
How Should I Sign Up For SilverScript?
The SilverScript website provides an option to register for a member account. To register an account for a prescription drug plan, you will need to provide either a Member ID, personal information for verification questions, or a prescription number. To see potential plan options in your area, visit their website here.
How Do You Pay Online With SilverScript?
Aetna Medicare, which SilverScript partners with, has the option of signing up for an online portal that allows you to pay your bills, check claims, and more. You can visit Aetna here.
What Pharmacies Include SilverScript?
Currently, the following pharmacies are included in SilverScript’s preferred pharmacies:
Walmart
Wegmans
CVS
Kroger
Publix
Some local pharmacies
Does SilverScript Allow Mail-Order Pharmacies?
Yes, SilverScript has mail-order options for those who choose the SilverScript Choice or Silverscript Plus plan options.
What is the Average Review for SilverScript?
SilverScript currently holds a 3.5 out of 5 stars for a Medicare Star Rating (which is considered an excellent score).
What are Drug Tiers?
Drug tiers are the different levels that a Part D plan provides within its formulary. A formulary is a list of all of the drugs a Part D plan will cover. Each tier represents a different type and cost for different drugs, and it’s broken down into the following:
Tier 1: Preferred generic
Tier 2: Generic
Tier 3: Preferred
Tier 4: Nonpreferred
Tier 5: Specialty
Different plans will have different copays depending on the tier selected.
Sources
Sources
- https://www.aetnamedicare.com/en/compare-plans-enroll/part-d-prescription-drug-plans.html
- https://www.medicare.gov/drug-coverage-part‑d/costs-for-medicare-drug-coverage/costs-in-the-coverage-gap
- https://www.medicare.gov/drug-coverage-part‑d/costs-for-medicare-drug-coverage
- https://www.medicare.gov/drug-coverage-part‑d/how-to-get-prescription-drug-coverage
- https://www.medicare.gov/drug-coverage-part‑d/what-medicare-part-d-drug-plans-cover
- https://www.medicare.gov/basics/costs/medicare-costs
- https://www.aetnamedicare.com/en/prescription-drugs/extra-help-pay-medicare-prescriptions.html
- https://www.ncdoi.com/SHIIPNextYear/Documents/PDP%20Summary/SilverScript%20Choice%20S5601-016.pdf
FAQs
What Is SilverScript: Everything You Need to Know? ›
SilverScript is one of the largest providers in the United States of Medicare Part D prescription drug coverage plans. SilverScript Medicare Part D plans are available in all 50 states (with the exception of the SilverScript Plus plan, which is unavailable in Alaska), and they offer three different plan options.
Is SilverScript a good drug plan? ›Aetna/SilverScript: Best overall
These popular plans are affordable and highly rated. Aetna and SilverScript plans are a good choice for most people because they are priced affordably, typically have a lower deductible than other companies and have a high average rating across most performance categories.
Premiums for SilverScript plans can start as low as $0 if you qualify for Extra Help. If not, here's the range of monthly premiums you'll pay for each plan in 2021: SilverScript SmartRx: $5.70 to $7.80. SilverScript Choice: $18.10 to $49.70.
What are the benefits of SilverScript? ›- $0 deductible on all tiers.
- $0 copays on Tier 1 and 2 drugs.
- A variety of prescription vitamins, minerals and generic erectile dysfunction drugs.
- Formulary insulins on all tiers for no more than a $35 copay***
Aetna is owned by CVS Health, so a SilverScript plan may be used at any CVS pharmacy. CVS is a preferred in-network pharmacy. Walgreens is a standard in-network pharmacy. While SilverScript plans may be used at Walgreens, the savings may not be as high as they would at a preferred in-network pharmacy such as CVS.
What is the star rating for SilverScript? ›The SilverScript family includes several distinct plans. Aetna Medicare SilverScript Part D (PDP) plans earned an overall 3.5 out of 5 Star Rating from Medicare in 2022. Above costs taken from the Kaiser Family Foundation.
What pharmacies are preferred for SilverScript 2023? ›Preferred Pharmacies tend to have lower copayments and coinsurance; SilverScript has over 23,000 pharmacies they consider Preferred. CVS, Publix, Walmart, and Kroger are a few preferred pharmacies.
Is GoodRX better than Medicare Part D? ›While GoodRX is not a replacement for your Medicare prescription drug plan, it may help you save money on some of your medications, especially those that aren't covered by Medicare. Occasionally we have even found that coupons from GoodRX that offer lower prices than the copay's in a Part D Drug plan!
What is the deductible for SilverScript choice? ›| Plan | Pricing |
|---|---|
| SilverScript Choice | Monthly premiums: Lowest: $24.30. Average: $34.34. Highest: $40.70. Annual deductible: $505. |
| SilverScript Plus | Monthly premiums: Lowest: $67.90. Average: $75.70. Highest: $105.20. Annual deductible: $0. |
SilverScript Insurance Company, a CVS Health Company, Introduces Three Medicare Prescription Drug Plan Options for 2019. We enter our 60th year as one of the most trusted brands in America.
Does SilverScript have a copay? ›
SilverScript drugs plans include multiple coverage benefits, including: $0 copays for preferred generic drugs. Access to a network of more than 65,000 pharmacies, including thousands of preferred pharmacies with additional discounts. Potential $0 deductible for all covered drugs.
Which is better SilverScript Choice or Plus? ›The SilverScript Plus (PDP) offers a $0 deductible for medications on all tiers. The policy has even more drug coverage than the SilverScript Choice (PDP), and you can get your prescription drugs delivered at no additional cost. This prescription drug plan is a fantastic option for those who take high-tier drugs.
Does Walgreens accept SilverScript? ›Since 2021, Walgreens has focused on participation in preferred networks. For 2023, it will be preferred in nine plans. However, for 2023, Walgreens will be an out-of-network pharmacy for Aetna's SilverScript SmartSaver.
Is SilverScript connected to CVS? ›Medicare Prescription Plan – SilverScript administered by CVS Caremark.
How is Aetna SilverScript rated? ›All of Aetna's PDPs have a Medicare star quality rating of 3.5 out of five stars. Aetna's SilverScript Smart Saver plan has the lowest average monthly premium in 2023, and CVS is one of four main providers of stand-alone Part D prescription drug plans in the United States.
What is SilverScript called now? ›SilverScript is now part of Aetna Medicare
Access and print plan documents. Pay your premium. Check drug coverage. Locate a pharmacy.
For 2022, the average Medicare Advantage plan with integrated Part D coverage (MA-PD) received 4.37 stars, up from 4.06 stars in 2021 (average is weighted by enrollment). And the average stand-alone Part D plan received 3.7 stars (up from 3.58 in 2021).
How many SilverScript plans are there? ›There are three Silver Script Medicare Prescription Drug Part D plan options. SilverScript Medicare Part D is available nationwide.
Do Medicare Advantage plans cover the donut hole? ›Some people ask: Do Medicare Advantage plans cover the donut hole? If you choose to include Medicare prescription drug coverage in your Medicare Advantage plan, it will still have a donut hole just like a regular Part D plan. Medicare Advantage does not cover any additional Part D costs during the coverage gap.
What is SilverScript premium for 2023? ›For the largest PDP, CVS Health's SilverScript Choice, which has a total of 3.0 million enrollees in 2022, including 1.4 million non-LIS enrollees, the average monthly premium will increase by $2 (+8%), from $31 in 2022 to $33 in 2023.
Is Costco a preferred pharmacy for SilverScript? ›
Aetna's Nationwide Network Of Preferred Pharmacies
Additionally, SilverScript members benefit from a large nationwide network of 65,000 well-known pharmacies like CVS, Costco, Giant Eagle, Kroger, Publix, Rite Aid, Safeway, Sam's Club, Target, Wegmans, Walgreens, Walmart, Winn Dixie, and many others.
The top-selling Medicare Part D drugs of all time include Revlimid, Eliquis, Xarelto, Januvia, Imbruvica, Trulicity, Ibrance, and Humira. According to an analysis from Xtelligent Healthcare Media's Research Team, Eliquis, Revlimid, and Xarelto remained the top-three-selling Medicare Part D drugs from 2018 to 2020.
Why are some Medicare Part D plans so expensive? ›However, each plan can generally choose which two drugs to cover in each class, and sets its own cost-sharing for covered drugs. This is one reason for some of the cost differences among Medicare prescription drug plans.
What is the max out of pocket for Medicare Part D? ›Medicare Part D plans don't have hard out-of-pocket maximums. However, in all Part D plans, you enter what's called the catastrophic coverage phase after you hit $7,400 in out-of-pocket costs for covered drugs.
What is the maximum Part D deductible? ›Once you have met the deductible, the plan will begin to cover the cost of your drugs. While deductibles can vary from plan to plan, no plan's deductible can be higher than $505 in 2023, and some plans have no deductible.
What is the standard Part D deductible? ›Deductibles vary between Medicare drug plans. No Medicare drug plan may have a deductible more than $505 in 2023. Some Medicare drug plans don't have a deductible. In some plans that do have a deductible, drugs on some tiers are covered before the deductible.
Do prescriptions go against your deductible? ›If you have a combined prescription deductible, your medical and prescription costs will count toward one total deductible. Usually, once this single deductible is met, your prescriptions will be covered at your plan's designated amount. This doesn't mean your prescriptions will be free, though.
Does SilverScript have a donut hole? ›About Your Benefits
SilverScript is the Medicare Part D prescription drug plan for members of the State Employee Health Plan. They offer two plans, Premium and Economy. The Premier Plan has a $0 deductible. It has 5 Tiers and offers coverage through the Gap (Donut-Hole) on all tiers.
You can use your card or download the free Healthy Benefits Plus app to buy approved foods like fruits, veggies, dairy products, meats and seafood, and pantry staples. As an Aetna D-SNP member, you also have a personal care team. They are there to make getting the care you need easier.
How do I cancel SilverScript? ›How to drop your Medicare drug plan Call us at 1-800 MEDICARE (1-800-633-4227). TTY: 1-877-486-2048. Mail or fax a signed written notice to the plan telling them you want to disenroll. Submit a request to the plan online, if they offer this option.
What are Tier 1 prescription drugs? ›
Tier 1: Least expensive drug options, often generic drugs. Tier 2: Higher price generic and lower-price brand-name drugs. Tier 3: Mainly higher price brand-name drugs.
What is a stand alone prescription drug plan? ›A stand-alone prescription drug coverage plan helps cover the cost of prescription drugs. It can be an addition to an existing health plan, such as Medicare. A stand-alone prescription drug plan helps reduce the amount people have to pay for prescription drugs.
Did CVS sell SilverScript to Aetna? ›6. When did CVS and Aetna start selling individual PDPs? Since 2006, CVS has sold its individual PDPs through a wholly-owned subsidiary called SilverScript Insurance Company. Similarly, Aetna has sold its individual PDPs since 2006.
What are the top 10 prescription drugs? ›- Top 10.
- Lisinopril.
- Levothyroxine.
- Atorvastatin.
- Metformin.
- Simvastatin.
- Omeprazole.
- Amlodipine.
Medicare rating: 3.5 stars
Aetna has a longstanding reputation in the insurance industry. Aetna's Part D plans have an overall quality rating of 3.5 out of 5 stars from the Centers for Medicare & Medicaid Services (CMS).
According to the data, the largest number of enrollees in Medicare Part D were covered via three payers: UnitedHealth, Humana and CVS Health. Specifically, 23% were covered by UnitedHealth, 17% were covered by CVS Health and another 17% by Humana.
Is Medicare Part D based on income? ›If you have a higher income, you might pay more for your Medicare drug coverage. If your income is above a certain limit ($97,000 if you file individually or $194,000 if you're married and file jointly), you'll pay an extra amount in addition to your plan premium (sometimes called “Part D-IRMAA”).
Who are Silverscript competitors? ›silverscript.com's top 5 competitors in April 2023 are: aetnamedicare.com, caremark.com, silverscriptonline.com, cvscaremark.com, and more.
Is WellCare and SilverScript the same company? ›SilverScript Update: Aetna Sells ALL Standalone Part D to WellCare | CareValue Insurance Marketing.
Who sponsors SilverScript? ›A proud member of the CVS Health family, SilverScript is one of America's largest5 stand-alone Medicare Part D prescription drug plan sponsors.
Are SilverScript stand-alone prescription drug plans sponsored by Aetna? ›
Members can pay their monthly premium at the register of CVS retail locations. SilverScript stand-alone prescription drug plans are sponsored by Aetna Medicare Solutions, a CVS Health company. Mail order prescription drug services are not available for SilverScript PDP plans.
Is SilverScript worth it? ›Aetna/SilverScript: Best overall
These popular plans are affordable and highly rated. Aetna and SilverScript plans are a good choice for most people because they are priced affordably, typically have a lower deductible than other companies and have a high average rating across most performance categories.
SilverScript® Plus (PDP)
$0 deductible on all tiers. $0 copays on Tier 1 and 2 drugs. A variety of prescription vitamins, minerals and generic erectile dysfunction drugs. Formulary insulins on all tiers for no more than a $35 copay***
Most Medicare drug plans have a Coverage Gap (also called the Medicare “donut hole”). This means there's a temporary limit on what the drug plan will cover for drugs. Not everyone will enter the Coverage Gap, and it doesn't apply to members who get Extra Help to pay for their Part D costs.
Does Walmart accept SilverScript? ›SilverScript is accepted at many local pharmacies and large retail chains like Walmart, CVS, and Walgreens. Preferred Pharmacies tend to have lower copayments and coinsurance; SilverScript has over 23,000 pharmacies they consider Preferred. CVS, Publix, Walmart, and Kroger are a few preferred pharmacies.
What is SilverScript for seniors? ›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.
What will SilverScript premiums be in 2023? ›For the largest PDP, CVS Health's SilverScript Choice, which has a total of 3.0 million enrollees in 2022, including 1.4 million non-LIS enrollees, the average monthly premium will increase by $2 (+8%), from $31 in 2022 to $33 in 2023.
Who is SilverScript affiliated with? ›SilverScript is now part of Aetna Medicare
Access and print plan documents. Pay your premium. Check drug coverage. Locate a pharmacy.
SilverScript drugs plans include multiple coverage benefits, including: $0 copays for preferred generic drugs. Access to a network of more than 65,000 pharmacies, including thousands of preferred pharmacies with additional discounts. Potential $0 deductible for all covered drugs.
What is the new name for SilverScript? ›The plan will have a name change for 2023. The new name will be the SilverScript Smart Saver.
Does SilverScript have a new name? ›
SilverScript SmartRx (PDP) is becoming SilverScript SmartSaver (PDP) Here is what you need to know: The plan name change will not affect the level of benefits and services you have come to expect from us. Your current SilverScript member ID card is still valid in 2023.
What is the out-of-pocket limit for Medicare Part D in 2023? ›The Medicare Part D true (or total) out-of-pocket (TrOOP) threshold will bump up to $7,400 in 2023, a $350 increase from the previous year. The true (or total) out-of-pocket (TrOOP) threshold marks the point at which Medicare Part D Catastrophic Coverage begins.
What is the out-of-pocket maximum for Medicare in 2023? ›Medicare Advantage (Part C): In 2023, the out-of-pocket maximum for Part C plans is $8,300 for approved services, but individual plans can set lower limits if they wish. Part D cost sharing does not apply towards your Medicare Advantage plan's MOOP.
Do I need Medicare Part D if I have SilverScript? ›Key points you need to know
SilverScript is a Medicare Part D prescription drug plan (PDP) with additional coverage provided by Pfizer. This additional coverage means that you have more coverage than the standard Medicare Part D plan. You don't have to do anything to continue your enrollment in the plan.
Additionally, SilverScript members benefit from a large nationwide network of 65,000 well-known pharmacies like CVS, Costco, Giant Eagle, Kroger, Publix, Rite Aid, Safeway, Sam's Club, Target, Wegmans, Walgreens, Walmart, Winn Dixie, and many others.