Clear Spring Health Premier Rx (Enhanced PDP) A 2023 Medicare Part D Plan Review
Clear Spring Health Premier Rx is a 2023 Enhanced Medicare 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 (S6946-046) from Clear Spring Health that's available to beneficiaries enrolled in a Medicare Advantage plan without Part D benefits or Medicare Part A and/or Part B.
This Part D plan has an Once 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 and a $505.00 A deductible is an amount a beneficiary must pay for their health care expenses before the health insurance policy begins to pay its share. that must be paid before cost-sharing begins. CMS rated this plan 1.5 (Poor) out of 5 stars.
- It is an enhanced benefit Medicare Part D plan from Clear Spring Health.
- The plan's monthly premium is $17.60, and there's a $505.00 annual deductible.
- Enhanced plans, like Clear Spring Health Premier Rx, have a higher actuarial value than basic benefit plans.
- Actuarial value simply refers to the percentage of cost covered by the plan.
- Enhanced plans generally have higher monthly A 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. than basic benefit plans but offer more benefits.
- This plan does not offer additional coverage in the coverage gap (aka, "donut hole").
- This plan does not qualify for the Extra Help program's full Social 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....
- It's important to remember that benefits vary from plan to plan.
|Rx Gap Coverage:||No|
|Low Income Subsidy:||No|
|Insured By:||Clear Spring Health|
WARNING: Before enrolling in a Part D plan, take the time to evaluate the cost of your regular prescriptions.
Prescription Drug Plan Premium
Although Clear Spring Health Premier Rx'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 Clear Spring Health plan.
|Basic Part D Premium:||-$8.40|
|Supplemental Part D Premium:||$26.00|
|Total Part D Premium:||$17.60|
|Part D Premium with Full LIS Assistance:||$17.60|
|Part D Premium with 75% LIS Assistance:||$17.60|
|Part D Premium with 50% LIS Assistance:||$17.60|
|Part D Premium with 25% LIS Assistance:||$17.60|
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 $505.00. This is the amount you must pay at the pharmacy before Clear Spring Health begins paying its share.
NOTE: The deductible does not apply to one or more drug tiers in this plan (see "Prescription Drug Plan Out-of-Pocket Costs" below).
Prescription Drug Plan Out-of-Pocket Costs
In addition to the plan's monthly premium and deductible, Clear Spring Health Premier Rx has A 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.
|1 (Preferred Generic)||$1.00 copay|
(deductible does not apply)
(deductible does not apply)
|2 (Generic)||$5.00 copay||$20.00 copay|
|3 (Preferred Brand)||$42.00 copay||$47.00 copay|
|4 (Non-Preferred Drug)||45%||50%|
|5 (Specialty Tier)||25%||25%|
Our Review & 2023 CMS Rating Marks
This Medicare Part D plan gets 1.5 out of 5 stars overall. Here's our quick summary of how well Clear Spring Health Premier Rx performs.
Think twice before joining this sub-par Medicare Part D plan. Clear Spring Health Premier Rx does a poor job at customer service. This plan gets an excessive number of complaints from its members. Members report that their experience with this plan is below average. Drug safety and the accuracy of drug pricing with this plan are about average.
Every plan covers drugs differently, so it's important to look at your total cost. Although the premium for most enhanced benefit plans is higher than this one, you'll need to make sure it offers greater value in terms of the medications you require. This plan has a deductible, but one tier is excluded (see table above).
Each year the The Centers for Medicare & Medicaid Services (CMS) is the U.S. Federal agency that runs the Medicare, Medicaid, and Children’s Health Insurance Programs. (CMS) rates drug plans (Part D) in four broad categories. We do not recommend joining a plan with an overall rating of less than 3.0. Here are the most recent CMS ratings for 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|
Clear Spring Health Premier Rx is available in the following states:
Contact Clear Spring Health
|Plan Website:||Clear Spring Health Plan Information|
|Formulay Information:||Clear Spring Health Formulary Information|
|Pharmacy Information:||Clear Spring Health Pharmacy Information|
|Prospective Members:||(877) 317-6082|
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 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
- Clear Spring Health, "http://www.clearspringhealthcare.com", Last Accessed October 15, 2021
- Medicare.gov, "Your Guide to Medicare", Last Accessed September 3, 2022
- Medicare.gov, "How Part D works with other insurance", Last Accessed August 14, 2022
- Medicare.gov, "Costs for Medicare drug coverage", Last Accessed June 3, 2022
- SSA.gov, "Understanding the Extra Help With Your Medicare", 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 .