2025 Medicare Prescription Drug Plan Cost-Sharing Details
| 2025 Medicare Prescription Drug Formulary (Drug List) Cost-Sharing Details | ||||||
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SilverScript Choice (PDP) (S5601-008-0) Benefits & Contact Info 
 all covered insulin pay $35 or less | ||||||
| This plan is available in CMS PDP Region 4 Click on a letter below to view the SilverScript Choice (PDP) Formulary A B C D E F G H I J K L M N O P Q R S T U V W X Y Z 0-9 | ||||||
| 30-Day Supply Cost-Sharing |
90-Day Supply Cost-Sharing |
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| Preferred Pharmacy | Standard Pharmacy | Mail- Order* | Preferred Pharmacy | Standard Pharmacy | Mail- Order* | |
| Initial Deductible Phase Cost Sharing | ||||||
| All Formulary Drug Tiers: | 100% | 100% | 100% | 100% | 100% | 100% |
| Initial Coverage Phase Cost-Sharing | ||||||
| Tier 1: Preferred Generic: | $5.00 | $5.00 | $5.00 | $15.00 | $15.00 | $15.00 |
| Tier 2: Generic: | $10.00 | $10.00 | $10.00 | $30.00 | $30.00 | $30.00 |
| Tier 3: Preferred Brand: | 19% | 19% | 19% | 19% | 19% | 19% |
| Tier 4: Non-Preferred Drug: | 32% | 32% | 32% | 32% | 32% | 32% |
| Tier 5: Specialty Tier: | 25% | 25% | 25% | n/a | n/a | n/a |
| Catastrophic Coverage Phase Cost Sharing | ||||||
| All Formulary Drugs: |
$0 cost-sharing. The Inflation Reduction Act (IRA) of 2022 eliminates beneficiary cost-sharing once your TrOOP reaches the established maximum cap on out-of-pocket spending for Part D formulary drugs (RxMOOP). | |||||
| Go to the SilverScript Choice (PDP) 2025 Formulary Browser by choosing a letter below: A B C D E F G H I J K L M N O P Q R S T U V W X Y Z 0-9 | ||||||