2009 Medicare Prescription Drug Plan Details | |||||
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Medicare Plan Name: | SilverScript Complete by SilverScript Insurance Company | ||||
State: | Hawaii | ||||
Plan ID: | S5601 - 104 - 0 Click to see other plans | ||||
Member Services: | 1-866-235-5660 TTY users 1-866-236-1069 | ||||
— This plan information is for research purposes only. — Click here to see plans for the current plan year | |||||
Medicare Contact Information: | Please go to Medicare.gov or call 1-800-MEDICARE (1-800-633-4227) to get information on all of your options. TTY users 1-877-486-2048 or contact your local SHIP for assistance |
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Email a copy of the SilverScript Complete benefit details | |||||
— Medicare Plan Features — | |||||
Monthly Premium: | $63.40 | ||||
Annual Deductible: | $0 | ||||
$0 Premium if LIS Benefits? | No, this plan does NOT qualify for the $0 Premium. | ||||
Gap Coverage? | Many Generics | ||||
Total Number of Formulary Drugs: | 5,320 drugs | Browse the SilverScript Complete Formulary | |||
This plan has 5 drug tiers. See cost-sharing highlights below. | |||||
Formulary Drug Details: | Tier 1 | Tier 2 | Tier 3 | Tier 4 | Tier 5 |
• Preferred Pharmacy Cost-Sharing during initial coverage phase: | $2.50 | $7.50 | $39.00 | $98.00 | 33% |
• Number of Drugs per Tier: | 178 | 1968 | 1033 | 1855 | 286 |
Plan Offers Mail Order? | Yes | ||||
Plan Type (Reach): | National Plan | ||||
Number of Members enrolled in this plan in Hawaii: | 21 members (CMS Region 33) | ||||
Number of Members enrolled in this plan nationally: | 18,368 members |