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2025 Medicare Prescription Drug Plan Benefit Details for the Clear Spring Health Value Rx (PDP) - S6946-026
2025 Medicare Prescription Drug Plan Details
Medicare Plan Name:Clear Spring Health Value Rx (PDP)
   by Clear Spring Health
State:Idaho
Plan ID:S6946 - 026 - 0     Click to see other plans
Member Services:(877)317-6082 TTY users 711
— This plan is currently sanctioned and is not accepting enrollments —
Read more here...
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
Email a copy of the Clear Spring Health Value Rx (PDP) benefit details
— Medicare Plan Features —
Monthly Premium:$11.50 (see Plan Premium Details below)
Annual Deductible:$590 (Tier excluded from the Deductible.)
$0 Premium if LIS Benefits?Yes, this plan does qualify for the $0 Premium. (See premium for LIS subsidy beneficiaries below.)
Drug Benefit Type ❔Actuarially Equivalent Standard (AE)
Formulary Exception Tier:Tier 4 If your formulary exception request is approved, your drug will be placed on this tier.
This plan has 5 drug tiers. See cost-sharing for all pharmacies and tiers. 
Insulin on a Medicare Part D plan's formulary will have a monthly copay of $35 or less.
Formulary Drug Details:Tier 1Tier 2Tier 3Tier 4Tier 5
• Preferred Pharmacy
  Cost-Sharing during
  initial coverage phase:		$1.00$3.0018%41%25%
Plan's Pharmacy Search:http://www.clearspringhealthcare.com
Plan Offers Mail Order?Yes
Plan Type (Reach):Regional Plan
Number of Members enrolled in this plan in your CMS Region:3,415 members     (CMS Region 31)
Number of Members enrolled in this plan nationally:345,247 members
Plan’s Summary Star Rating: 2 out of 5 Stars.
• Customer Service Rating: Insufficient data to rate this plan.
• Member Experience Rating: 1 out of 5 Stars.
• Drug Cost Accuracy Rating: 2 out of 5 Stars.
— Plan Premium Details —
The Monthly Premium is Split as Follows: ❔
Total
Premium		Part D Basic
Premium		Part D Supplemental
Premium
$11.50$11.50$0.00
Monthly Premium with Extra Help Low-Income Subsidy (LIS): ❔ $0.00




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