SilverScript Plus (Enhanced PDP) A 2023 Medicare Part D Plan Review
SilverScript Plus is a Enhanced Part D plan (S5601-041) from SilverScript that's available to people with Original Medicare or a Medicare Advantage plan without Part D benefits.
This 2023 plan has a $0.00 annual deductibleA deductible is an amount a beneficiary must pay for their health care expenses before the health insurance policy begins to pay its share. and an initial coverage limitOnce you have met your yearly deductible, you will pay a copayment or coinsurance for each covered drug until you reach the initial coverage limit. You will then enter your plan’s coverage gap (aka, “donut... of $4,660. This plan is rated 3.5 (Above Average) stars by CMS.
Key Takeaways
- SilverScript Plus is an enhanced benefit Medicare Part DMedicare Part D plans are an option Medicare beneficiaries can use to get prescription drug coverage. Part D plans provide cost-sharing on covered medications in four different phases: deductible, initial coverage, coverage gap, and catastrophic. Each... plan.
- Enhanced benefit plans have a higher actuarial value than basic benefit plans.
- Actuarial value simply refers to the percentage of cost covered by the plan.
- The monthly premiumA premium is an amount that an insurance policyholder must pay for coverage. Premiums are typically paid on a monthly basis. In the federal Medicare program, there are four different types of premiums. is $75.90
- The annual deductible is $0.00.
- This SilverScript plan offers additional coverage in the coverage gap (aka, "donut hole").
- This plan does not qualify for the Extra Help program's full low-income subsidySocial Security's Low-Income Subsidy (LIS) program helps Medicare beneficiaries pay for their Medicare Part D prescription drugs by paying some of the costs. Also known as "Extra Help", beneficiaries who qualify for LIS receive premium....
- Benefits and prescription costs vary widely from plan to plan, so if you have regular prescriptions it's important to carefully compare what your costs will be.
| Plan Basics | |
|---|---|
| Plan ID: | S5601-041 |
| Plan Type: | PDP |
| Plan Year: | 2023 |
| Premium: | $75.90/mo |
| Deductible: | $0.00/yr |
| Benefit Type: | Enhanced |
| Rx Gap Coverage: | Yes |
| Low Income Subsidy: | No |
| Availability: | See List |
| Insured By: | SilverScript |
WARNING: Before enrolling in this or any other Medicare Part D plan, it is very important to understand what your costs will be for your regular prescriptions.
Prescription Drug Plan Premium
Although SilverScript Plus's monthly premium is bundled with the total plan cost, some plans have supplemental costs and/or offer low-income subsidy (LIS) assistance. The following table outlines the premium details of this SilverScript plan.
| Basic Part D Premium: | $20.90 |
| Supplemental Part D Premium: | $55.00 |
| Total Part D Premium: | $75.90 |
| Part D Premium with Full LIS Assistance: | $55.00 |
| Part D Premium with 75% LIS Assistance: | $60.20 |
| Part D Premium with 50% LIS Assistance: | $65.40 |
| Part D Premium with 25% LIS Assistance: | $70.70 |
For more information about the Low-Income Subsidy (aka, "Extra Help") program, refer to the Social Security Extra Help page.
Prescription Drug Plan Deductible
The Medicare Part D annual deductible with this plan is $0.00. This is the amount you must pay at the pharmacy before SilverScript begins paying its share.
Prescription Drug Plan Out-of-Pocket Costs
In addition to the plan's monthly premium and deductible, SilverScript Plus has copaymentsA copayment, also known as a copay, is a set dollar amount you are required to pay for a medical service. (a fixed dollar amount) and/or coinsurances (a percentage amount) that you must pay when you pick up your prescriptions. The following table shows you those costs.
| Tier | Preferred | Standard |
|---|---|---|
| 1 (Preferred Generic) | $0.00 copay | $5.00 copay |
| 2 (Generic) | $0.00 copay | $14.00 copay |
| 3 (Preferred Brand) | $47.00 copay | $47.00 copay |
| 4 (Non-Preferred Drug) | 50% | 50% |
| 5 (Specialty Tier) | 33% | 33% |
CMS Rating Marks and Our Review
This Medicare Part D plan gets 3.5 out of 5 stars overall. Here's our quick summary of how well SilverScript Plus performs.
In terms of quality, safety, and customer service, this Part D plan is just average. SilverScript Plus delivers an excellent customer care experience when members call for help. Compared to other plans, Medicare gets relatively few member complaints about this plan. Members report that their experience with this plan is below average. When it comes to drug safety and the accuracy of drug pricing, this plan is below average.
You can't judge a Part D plan on its monthly premium or annual deductible. You have to look at the overall cost of your prescriptions. There are enhanced benefit plans with a lower monthly premium than this one. That's okay if the plan covers your prescriptions at a better overall price. This plan comes with a zero-dollar deductible, so you have first-dollar coverage.
Each year Medicare rates drug plans (Part D) in several major categories. These ratings are designed to help you understand the quality of care and service you can expect if you join this plan:
| CMS Measure | Star Rating |
|---|---|
| Overall Plan 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 |
Plan Availability
SilverScript Plus is available in the following states:
Contact SilverScript
| Plan Website: | SilverScript Plan Information |
|---|---|
| Formulay Information: | SilverScript Formulary Information |
| Pharmacy Information: | SilverScript Pharmacy Information |
| Prospective Members: | (866)552-6106 |
| TTY Users: | (711)- |
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 AdvantageMedicare Advantage (MA), also known as Medicare Part C, are health plans from private insurance companies that are available to people eligible for Original Medicare (Medicare Part A and Medicare Part B). program on www.medicare.gov.
Citations & References
- SilverScript, "http://www.aetnamedicare.com", Last Accessed October 15, 2021
- Medicare.gov, "How to get prescription drug coverage", Last Accessed August 28, 2022
- Medicare.gov, "What Medicare Part D drug plans cover", Last Accessed July 1, 2022
- Medicare.gov, "Medicare costs at a glance", Last Accessed June 11, 2022
- SSA.gov, "Extra Help with Medicare Prescription Drug Plan Costs", Last Accessed June 9, 2022
- CMS.gov, "Landscape Source Files", Last Accessed January 15, 2023
- CMS.gov, "Medicare Part C & D Performance", Last Accessed January 15, 2023
The 2023 Medicare Part D Plans for information on this page was last updated on .