What is SilverScript?
SilverScript is a prescription drug plan (Part D) and a company owned by pharmacy giant CVS. When CVS acquired Aetna, SilverScript became part of Aetna Medicare for 2021. SilverScript is the largest provider of Medicare Part D plans in all 50 states.
There are two individual plans within SilverScript. Many customers may find this a limitation, however we have found that the two stand-alone plans fit the insurance needs of most customers. One of the biggest benefits is that there is $0 deductible available for all medication tiers.
Being connected to CVS also means that customers have the benefit of over 9,800 retail locations and 1,100 walk in medical clinics.
Originally, SilverScript had three Part D prescription drug plans, but in 2020 they narrowed the program down to two plans.
Basics of Medicare Part D (Prescription Drug Plans)
Before we delve into the details on the two SilverScript prescription drug offerings, you need a primer on Medicare Part D. Understanding the drug tiering will help you understand the differences between the SilverScript drug plans and which one is right for you.
Part D is Medicare’s prescription drug plan. Unlike Medicare Part A and B, Part D is administered by private carriers. The federal government has established specific guidelines for each insurance carrier administering the program, however, you will still find a wide range of variety and premiums depending on the program.
One of the biggest benefits of Part D is that plans cannot change within the year. Whichever plan you sign up for, you will lock your benefits in through the entire year. Costs are set and rules will not change.
Part D or some type of prescription drug insurance coverage is required by Medicare. If you don’t access prescription drugs through an employee plan or bundled inside of Medicare Advantage (Part C), you will need to find a plan.
To understand Medicare Part D prescription drug plans, some terminology is helpful. Inside of the Part D, you will hear the term formulary drugs. These are the list of covered drugs. Formularies are also the medicines branded by various pharmaceutical companies. All plans are federally mandated to include at least two drugs in each of their categories.
Generics are also covered under the term formulary. We have all purchased generic drugs. They are the same as formulary medicines but are not marketed under the pharmaceutical brand name.
What are Part D Coverage Formularies?
Formulary drugs are divided into multiple prescription groups called tiers. Here’s a breakdown of the various formulary tiers:
- Tier 1 is the lowest cost to you and provides generic drugs
- Tier 2 is the preferred tier with most brand-name drugs.
- Tier 3 are preferred brand name drugs that do not have a generic equivalent.
- Tier 4 are higher priced brand name and generic drugs not in the preferred tier.
- Tier 5 is the Speciality Tier that has the highest co-payment and high-cost prescription drugs.
SilverScript, like all other part D prescription plans will have different deductibles, copays, and out of pockets for each tier.
To find if your specific drugs are covered you can visit Medicare’s site here which will provide more details into which part D plan is best for you.
SilverScript Part D Plans
Now that you understand the basics of Part D drug tiering, we can detail the two basic SilverScript Medicare Part D prescription plans offered by SilverScript insurance.
The two plans are the SilverScript Choice and SilverScript Plus.
Coverage Basics for All Plans:
- – $0 copays for preferred generics
- – Access to a network of more than 65,000 pharmacies nationwide
- – Lower copays at preferred pharmacies
- – Cost-saving plans available for 90-day mail-order refills
SilverScript Smart RX Coverage
SilverScript SmartRX is the entry-level plan and comes with $0 deductible for drugs in Tiers 1 &2.
Currently, there is a $445 deductible for drugs in Tiers 3 to 5. The copay for Tier 1 drugs at preferred pharmacies is $0 and the copay for Tier 2 Drugs is $1.
This plan also offers access to over 65,000 standard preferred pharmacies. This allows for coverage nationwide. Their online tools and website are very interactive and intuitive. They have received high marks for their 24/7 customer support line as well.
Details of Drug Tiering inside of SmartRx:
- Tier 1: $0 at preferred pharmacies and mail-order service; $19 for a 30-day supply at non preferred pharmacies
- Tiers 2 and 3: $19 to $141 (range for all pharmacies and supply amounts)
- Tier 4: 48 percent to 50 percent coinsurance
- Tier 5: 25 percent coinsurance for a 30-day supply
SilverScript Choice is the more comprehensive plan. It comes with a $0 deductible for drugs in Tiers 1 & 2, and $205 to $445 deductible for drugs in Tiers 3 to 5.
The copay for Tier 1 drugs is $0 and the copay for Tier 2 drugs is $2.
Details of Drug Tiering inside of SilverScript Choice
- Tiers 1 and 2: $0 at preferred pharmacies and mail-order service; $5 to $33 for all pharmacies and supply amounts
- Tier 3: $35 to $141 range for all pharmacies and supply amounts
- Tier 4: 41 percent coinsurance
- Tier 5: 27 percent coinsurance for a 30-day supply
This insurance plan is designed for customers who take a wide range of medications that tend to specialize per condition rather than basic drugs that many seniors might take. Because it is a more comprehensive plan, the premiums are higher than the SilverScript Choice plan, but as you have seen the deductibles and copays are much less for all drug tiers.
Does SilverScript Have Preferred Pharmacies?
Regardless of which SilverScript plan you choose, you will have access to these benefits. Even though SilverScript is owned by the CVS group of companies, you are not forced to use CVS as your pharmacy. They work with a large network of over 65,000 well known pharmacies such as:
CVS, Costco, Giant Eagle, Kroger, Publix, Rite Aid, Safeway, Sam’s Club, Target, Wegmans, Walgreens, Walmart, Winn Dixie and others.
Within the group of pharmacies, there are nearly 23,000 preferred pharmacies for the SmartRD and Choice plans.
Who is Eligible for SilverScript?
Anyone eligible for Medicare plans is eligible to purchase SilverScript as their Part D plan. If you already have a prescription drug through another program such as Medicare Advantage plan or through an employer, you can not sign up for a competing plan.
Many companies that offer Medicare products will partner with SilverScript for their Part D.
United American and SilverScript
United American is one of the largest providers of Medicare supplements. The company is licensed in 40 states and the District of Columbia. In New York, it operates under the subsidiary, First United American Life Insurance Company.
United American has partnered with SilverScript for its prescription drug plans. All insurance benefits are administered and sponsored by SilverScript.
SilverScript and the Donut Hole Cost
The Donut Hole can be the most confusing part of Part D prescription drug coverage. Many customers have questions around this term, because you hear it often in the news. In many ways the donut hole has disappeared and doesn’t affect seniors the way it used to impact them.
Basically after you’ve reached your initial coverage limit, you move into the coverage gap which is often called the donut hole. Different plans will charge you set copay amounts for your medication during this phase.
The limit is $4,130 in 2021 to reach the coverage gap. Most people never reach this limit of their drug coverage. This limit changes from year to year.
With SilverScript, you won’t be responsible for paying more than 25% of the plan’s cost for brand name and generic drugs while you are in the coverage gap.
Information About Enrolling in SilverScript
SilverScript is available to all seniors over 65 and eligible for Medicare. If you are interested in this program, you can access it regardless of which companies you may have for other Medicare products such as a Medicare Supplement policy.
SilverScript is one of the Part D insurance plans that we represent, and can provide you a quote and review the benefits provided.
While we highly recommend SilverScript, they may not be the best value and coverage for your situation. Any time you look at purchasing a Part D prescription drug plan, we recommend that you discuss your full health situation with one of our agents.
We will provide a quote for SilverScript, but will also provide other high-quality prescription drug plans as well.
Talk with one of our agents at Medicare Nationwide and we will find the best drug plan to fit your needs.
Prefer to chat by phone? Give us a call at 1-888-559-0103.