SilverScript Choice 2020 Arizona Medicare Part D Plan S5601-056

On this page we help consumers: Compare SilverScript Choice, a 2020 Medicare Prescription Drug Plan (PDP) available in Arizona for $30.50/month with a $415.00 deductible, with all Medicare Part D Plans in AZ.

According to the Centers for Medicare and Medicaid Services (CMS), this plan's quality is Above Average, and rated it 4.0 out of 5.0 stars.

These are the areas of the plan that are important to compare and review:

• Premium & Deductible: The premium is the amount you will pay monthly. Plud, many plans have an annual deductible that must be met before cost sharing begins.
• Coverage Phases: Part D plans have an initial coverage limit, followed by a coverage gap, and then catastropic coverage. Some plans offer some coverage in the gap.
• Co-pays & Co-insurance: If you have regular prescriptions, it's critical to verify that your drugs are covered and to know what you will pay at the pharmacy.
• CMS Ratings: Important measurements across 4 different areas that will help you understand how well this plan will care for you.

Cost Details

This is a cost sharing based prescription drug plan (PDP). With the SilverScript Choice PDP you have several different costs, including the premium (monthly), a deductible (annual), and pharmacy co-pays and/or co-insurance.

Premium

The monthly premium is $30.50 ($366.00 paid annually). It breaks down as follows:

Basic Premium:	$30.50
Supplemental Premium:	$0.00
Full Premium:	$30.50

Low-Income Subsidy

This plan qualifies for the full, low income subsidy benefit. The following table details subsidised premium amounts:

Subsidy Level	Monthly Premium
100%	$0.00
75%	$7.60
50%	$15.20
25%	$22.90

Deductible

The annual deductible is $415.00.

For 2020, the maximum Part D deductible is $435. A plan with the maximum deductible does not necessarily mean that it is more expensive than a plan with a lower deductible or no deductible at all. You need to consider all costs.

You Pay the Premium + Deductible + Copayments

Be aware that you must continue to pay your monthly premium even when you are not using any medications. Also, it's important to plan ahead because you are responsible for one hundred percent of your prescription costs until the plan's deductible has been met. You also make the required copayment when you pickup your prescriptions. These are your share of the prescription drug costs. The plan pays the rest until you reach the coverage gap (aka, “donut hole”).

What You Pay Could Be Different

There are two situations that can change your monthly premium. If your income is low and you are accepted into the Extra Help program administered by Social Security, your premium could be lower. It's also possible that your premium could be higher due to a late entry penalty. Be sure to speak with an authorized Arizona Medicare Insurance Agent to get an exact quote for your situation.

Coverage Details

SilverScript Choice is a Basic PDP. At a minimum, SilverScript must offer a "standard benefit" package mandated by law. The standard benefit includes an annual deductible and a gap in coverage, aka, donut hole. Carriers may also offer plans that:

• are actuarially equivalent to the standard benefit; or
• are enhanced, offering benefits in addition to the standard benefit.

Typically, enhanced plans offer additional coverage during the coverage gap. If you fell into the donut hole last year, shop enhanced plans.

Initial Coverage Limit

It's important to understand the initial coverage limit (ICL) and how it applies to you in Arizona. The ICL is where you share the cost of your prescriptions with the insurance company. You and SilverScript each pay your share until you reach a total of $4020.00 (retail spending) spent at the pharmacy on prescriptions. At that point you pay all costs yourself because you're in the coverage gap, as explained below.

Coverage Gap (aka, Donut Hole)

When you fall into the coverage gap, or donut hole as many people call it, you are basically uninsured and must pay for all of your prescription costs out-of-pocket. When you reach the coverage gap will all depend on your prescriptions. Most seniors never exceed the ICL and don't have to worry about it. If you are on a long-term medication that's costly, you could reach the donut hole very quickly.

In the coverage gap phase you are responsible for the full cost of your prescription drugs up until your total out-of-pocket expenses reach $6,350 (excluding premiums and expense paid by insurance) minus a 75% discount on both brand-name prescription drugs and generics. Once you reach $6,350 in out-of-pocket expenses, you're out of the coverage gap. At this point, you automatically get catastrophic coverage through Medicare, which assures you only pay a small amount for covered drugs for the remainder of the year.

Additional Gap Coverage

SilverScript Choice does not offer additional assistance in the coverage gap. If you reached the coverage gap last year and were not able to afford your medications, be sure to check with your local Arizona Medicaid office. You may qualify for additional assistance. The Social Security Administration's Extra Help program is another opportunity for seniors on Medicare who are not able to afford their prescriptions.

Copayment & Coinsurance Details

In addition to the monthly premium and annual deductible, the SilverScript Choice prescription drug plan has copayments (fixed dollar amount) and/or coinsurances (percentage) that you must pay when you pickup your medications. Here's the schedule for this plan:

Tier	Preferred	Standard
1 (Preferred Generic)	$0.00 copay	$5.00 copay
2 (Generic)	$1.00 copay	$6.00 copay
3 (Preferred Brand)	$47.00 copay	$47.00 copay
4 (Non-Preferred Drug)	38%	38%
5 (Specialty Tier)	25%	25%

IMPORTANT: In order to determine if this is the best PDP for you, it's critical that you look up your prescriptions in the plan's formulary.

Medicare Part D Star Ratings

In this section we show you the quality rating for this plan. Each year the Centers for Medicare and Medicaid Services (CMS) rates prescription drug plans in four broad categories. We do not recommend joining a plan with an overall rating less than 3.0. The following marks will give you an idea of the level of care you will receive if you join this SilverScript plan.

2020 Overall Rating
Drug Plan Customer Service
Complaints and Changes in the Drug Plan
Member Experience with the Drug Plan
Drug Safety and Accuracy of Drug Pricing

Contact SilverScript

Here's the new member contact information for SilverScript:

Prospective Members:	(866)552-6106
TTY Users:	(711)-
Plan Website:	http://www.silverscript.com
Formulay Information:	http://www.SilverScript.com
Pharmacy Information:	http://www.SilverScript.com

For assistance 24 hours a day, call 800-633-4227. TTY users should call 877-486-2048. If you qualify for Medicare but have not yet enrolled or verified your enrollment status, you can do so on the Social Security Administration website. You can learn more about the Medicare Part D program on www.medicare.gov or the Wikipedia page. For information about the SSA's Extra Help program, download the Understanding Extra Help guide.

Availability

If you are entitled to Medicare Part A (enrolled or not) or currently enrolled in Medicare Part B you may join the SilverScript Choice prescription drug plan. Unless you also receive benefits from Medicaid, enrollment in a Part D plan is voluntary. This plan is available in Scottsdale, Phoenix, Peoria, Surprise, Mesa, Tucson, Tempe, Yuma, Avondale, Buckeye, Chandler, Goodyear, Gilbert, Lake Havasu City, Flagstaff, Bullhead City, and all other towns and cities in Arizona.

The Medicare Part D information on this page originates from CMS Landscape Source Files, is maintained by David Bynon, and was last updated on October 2, 2019.