2025 Medicare Prescription Drug Plan Details | |||||
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Medicare Plan Name: | Clear Spring Health Value Rx (PDP) by Clear Spring Health | ||||
State: | Nebraska | ||||
Plan ID: | S6946 - 022 - 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 |
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Email a copy of the Clear Spring Health Value Rx (PDP) benefit details | |||||
— Medicare Plan Features — | |||||
Monthly Premium: | $8.90 (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 1 | Tier 2 | Tier 3 | Tier 4 | Tier 5 |
• Preferred Pharmacy Cost-Sharing during initial coverage phase: | $1.00 | $3.00 | 18% | 40% | 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: | 15,651 members (CMS Region 25) | ||||
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 | ||
$8.90 | $8.90 | $0.00 | |||
Monthly Premium with Extra Help Low-Income Subsidy (LIS): ❔ | $0.00 |