What Is SilverScript: Silverscript Part D, Everything You Need to Know

• 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 Medicare in 2021.

• There are different types of PDP plans that vary in coverage, providers, and cost.

• SilverScript provides a range of PDPs that include unique benefits including low premiums, coverage for Tier 1 drugs, and certain types of insulin coverage.

When it comes to Medicare, there are multiple options to choose from. Medicare is a federal 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 drug coverage.

The Medicare part that covers medication is known as Medicare Part D. When looking at Part D plans, there are quite a few companies that provide coverage to ensure you receive your necessary prescriptions. Today, we’re looking at the insurance company SilverScript, which specializes in Part D prescription drug plans.

Medicare Part D is Medicare’s prescription drug plan. These drug plans help cover a portion of a Medicare beneficiary’s medications. Medication costs can add up quickly and lead to large out-of-pocket costs without insurance. Medicare Part D plans help to shoulder the prescription drug costs so beneficiaries can get the medications they need. 

Medicare is broken into different sections, or parts, each one designed to cover specific healthcare services. The parts of Original Medicare are: 

• 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 a private insurance company, that may include Part D coverage, but this isn’t the case for all Medicare Advantage Plans.

If Original Medicare enrollees or those with a Medicare Advantage Plan without an existing Part D plan want prescription medication coverage, they’d need to enroll in a separate Medicare Part D plan, such as SilverScript.

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. In 2021, they joined Aetna Medicare.

The types of SilverScript Medicare Part D plans include SilverScript SmartSaver PDP, SilverScript Choice PDP, and SilverScript Plus PDP.

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 1 drugs ($0 copay at preferred pharmacies during the initial coverage phase), and more.

SilverScript Choice PDP

This plan provides more coverage than the SmartSaver plan, but does have a $505 deductible and $33.60 monthly premium (though if a person qualifies for the Extra Help program, they can receive a $0 monthly premium).

SilverScript Plus PDP

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 1 and 2 drugs, as well as a coverage gap for Tier 1 and Tier 2 drugs.

Note: for more information about SilverScript plans, visit this source.

When talking about costs for Part D plans, there are different costs associated with different parts, depending on the plan selected. These costs include deductibles, copays and coinsurance, and premiums.

Deductibles

Deductibles are the amount of money a person must pay before their health insurance kicks in. The different deductibles for each SilverScript plan are as followed:

• SilverScript SmartSaver: $0 deductible for Tier 1, $505 for Tiers 2–5

• SilverScript Choice: $505 deductible for all tiers

• SilverScript Plus: $0 deductible on all tiers

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 tier include:

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 90 day 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 90 day at preferred pharmacies 

Tier 4: 50% coinsurance for 30 or 90-day 

Tier 5: 33% coinsurance for 30-day

Premiums

Premiums are monthly fees that pay for insurance coverage. Premiums for each SilverScript plan are: 

• SilverScript SmartSaver: $5.92/month

• SilverScript Choice: $33.60/month

• SilverScript Plus: $75.58/month

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

• As low as $1 copay on Tier 1 drugs when filled at a preferred retail pharmacy

• Savings on certain insulins at a preferred pharmacy (only with certain plans)

• 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

When deciding on which Part D PDP option is right for you, there are a few things to consider.

Cost

When selecting a Part D plan, costs are always a factor 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 a person who is in great health and prefers to take generic drugs, you may opt for a plan with a lower premium and coverage for tier 1 or tier 2 drug options. If you have specific drugs you are prescribed, have significant health conditions, or need more definitive coverage, you may choose a plan with a higher 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 a large amount of coverage, you may prefer choosing a plan 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 a higher cost.

Flexibility

The flexibility you have towards the types of drugs and pharmacies you want to use will also play a part in choosing the best Part D plan. 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 best for you. 

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.