MedicarePartD.guide

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HealthSpring Assurance Rx (PDP)

Contract S5617, plan 158, segment 0 · offered by MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY · CMS PDP Region 32 (California).

Plan features

Monthly premium$0.00
Annual deductible$615.00
Drug benefit typeActuarially Equivalent Standard (AE)
$0 premium with full LISYes
Premium with Extra Help (LIS)—
Formulary drugs3,265
Formulary exception tier—
Mail order offered—
Plan reach—
Members in California—
Members nationally—
Member services—
BIN / PCN—

CMS star ratings

Summary rating
2.5 out of 5 stars for Summary rating
Customer service
—
Member experience
—
Drug pricing & patient safety
—

Formulary tiers — preferred pharmacy, initial coverage phase

TierCost-sharingDrugs on tier
Tier 15%—
Tier 210%—
Tier 325%—
Tier 429%—
Tier 525%—

Cost-sharing by coverage phase

Tier30-day supply90-day supply
PreferredStandardMail OrderPreferredStandardMail Order
Initial coverage phase
Tier 1: Preferred Generic5%10%5%5%10%5%
Tier 2: Generic10%15%10%10%15%10%
Tier 3: Preferred Brand25%25%25%25%25%25%
Tier 4: Non-Preferred Drug29%29%29%29%29%29%
Tier 5: Specialty Tier25%25%25%n/an/an/a
Catastrophic coverage phase
Tier 1: Preferred Generic0%0%0%0%0%0%
Tier 2: Generic0%0%0%0%0%0%
Tier 3: Preferred Brand0%0%0%0%0%0%
Tier 4: Non-Preferred Drug0%0%0%0%0%0%
Tier 5: Specialty Tier0%0%0%0%0%0%

Star rating measures

Measure20262025
Overall Star Rating2.52.5
Summary Rating of Prescription Drug Plan Quality2.52.5
Drug Plan Customer Service53
Call Center — Foreign Language Interpreter and TTY Availability53
Member Complaints and Changes in the Drug Plan’s Performance33
Complaints about the Drug Plan (higher score is better - means fewer complaints)44
Members Choosing to Leave the Plan (higher score is better - means fewer members leaving)21
Improvement (if any) in the Drug Plan's Performance33
Member Experience with the Drug Plan22
Members’s Rating of Drug Plan22
Ease of Getting Prescriptions Filled When Using the Plan22
Drug Safety and Accuracy of Drug Pricing32
Medicare.gov Plan Finder Drug Price Accuracy (higher score is better)54
Medication Adherence for Diabetes Medications22
Medication Adherence for Hypertension (RAS antagonists)12
Medication Adherence for Cholesterol (Statins)22
MTM Program Completion Rate for CMR42
Statin Use in Persons with Diabetes32

Benefits in plain text

The following Medicare Prescription Drug plan (PDP) benefits apply to the HealthSpring Assurance Rx (PDP) (S5617 - 158) in CMS Region 32 , which includes all counties in CA. This plan is administered by MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY, a national plan provider. This means that the insurance carrier offers Medicare Part D plan in most every state. To switch to a different Medicare Prescription Drug plan or to change your location, click here. Click here to see the HealthSpring Assurance Rx (PDP) prescription drug benefit details in chart format or email and view benefits chart Plan Premium This plan has a $0.00 monthly premium. Plan Membership and Plan Ratings The HealthSpring Assurance Rx (PDP) (S5617 - 158) in CMS Region 32 currently has 540,172 members, and 1,160,620 members in the HealthSpring Assurance Rx (PDP) nationwide. The Centers for Medicare and Medicaid Services (CMS) has given this plan carrier a summary rating of 2.5 stars. The detail CMS plan carrier ratings are as follows: Customer Service Rating of 5 out of 5 stars Member Experience Rating of 2 out of 5 stars Drug Cost Information Accuracy Rating of 3 out of 5 stars Prescription Drug Coverage: Deductible, Cost-sharing, Formulary This plan has a $615 deductible. So, you are 100% responsible for the first $615 in medication costs. After you have met the deductible, the HealthSpring Assurance Rx (PDP) will share the costs of your medications with you -- see cost-sharing below. $615 is the maximum deductible for 2026. There are other plans with a lower deductible or even a $0 deductible for all formulary drugs. Click here to review plans with a $0 deductible . The following information is about the HealthSpring Assurance Rx (PDP) formulary (or drug list). There are 3214 drugs on the HealthSpring Assurance Rx (PDP) formulary. The HealthSpring Assurance Rx (PDP) does offer a mail order service . Click here to browse the HealthSpring Assurance Rx (PDP) Formulary . The Initial Coverage Phase (ICP) can be thought of as the cost-sharing phase of the plan. During this phase, you and the insurance company share your prescription costs. Once you have spent $615, your initial coverage phase will start. All medication are divided into tiers within the plans formulary. This helps the plan to organize and manage the prescription cost-sharing. The HealthSpring Assurance Rx (PDP)’s formulary is divided into 5 tiers. Every plan can name their tiers differently, and can place medications on any tier. The cost-sharing for this plan is divided as follows: Tier 1 ( Preferred Generic ) contains 216 drugs and has a co-insurance of 50% of the drug cost. Tier 2 ( Generic ) contains 484 drugs and has a co-insurance of 10% of the drug cost. Tier 3 ( Preferred Brand ) contains 631 drugs and has a co-insurance of 25% of the drug cost. Tier 4 ( Non-Preferred Drug ) contains 1,172 drugs and has a co-insurance of 29% of the drug cost. Tier 5 ( Specialty Tier ) contains 762 drugs and has a co-insurance of 25% of the drug cost. All forms of insulin covered by this Medicare Part D plan will have a copay of $35 or less through all phases of coverage. Please contact the drug plan for more details. Click here to browse the HealthSpring Assurance Rx (PDP) Formulary .