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2017 Medicare Part D and Medicare Advantage Plan Formulary Browser
This is archive material for research purposes. Please see PDPFinder.com or MAFinder.com for current plans.
Select your search style and criteria below or use this example to get started

Search by:
State & Plan   ZIP & Plan   PlanID   FormularyID

Search Criteria
PDP     MAPD
Scroll down to see formulary results.

SilverScript Plus (PDP) (S5601-011-0)
Tier 1 (119)
Tier 2 (479)
Tier 3 (902)
Tier 4 (1154)
Tier 5 (530)
Requires Prior Authorization:
Yes No Show either
Uses Step Therapy:
Yes No Show either
Has Quantity Limits:
Yes No Show either
  *required
 
Cick on the first letter of your drug name to browse the 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 
2017 Medicare Part D Plan Formulary Information
SilverScript Plus (PDP) (S5601-011-0)
Benefit Details           
The SilverScript Plus (PDP) (S5601-011-0)
Formulary Drugs Starting with the Letter E
in CMS PDP Region 5 which includes: DC DE MD
Plan Monthly Premium: $81.90 Deductible: $0 Qualifies for LIS: No
Drugs Starting with Letter E

Drug Name		 Drug Tier Information Cost-Sharing Drug
Usage
Mgmt
Tier
Nbr.		 Tier
Description		 30-Day
Preferred
Pharm		 90-Day
Mail
Order
E.E.S. 400 FILMTAB   4 Non-Preferred Drug 40%40%None
EDURANT 27.5mg/1   5 Specialty Tier 33%N/ANone
EFFIENT 10 MG TABLET   4 Non-Preferred Drug 40%40%None
EFFIENT 5 MG TABLET   4 Non-Preferred Drug 40%40%None
ELIQUIS 2.5 MG TABLET   4 Non-Preferred Drug 40%40%P
ELIQUIS 5 MG TABLET   4 Non-Preferred Drug 40%40%P
Elitek 3 KIT per CARTON / 1 KIT in 1 KIT   5 Specialty Tier 33%N/AP
ELITEK 7.5 MG VIAL   5 Specialty Tier 33%N/AP
ELMIRON 100mg GELATIN COATED 100 CAPSULE BOTTLE   4 Non-Preferred Drug 40%40%None
EMBEDA ER 100-4 MG CAPSULE   3 Preferred Brand $27.00$67.50Q:60
/30Days
Drug Name Tier
Nbr.		 Tier
Description		 30-Day
Preferred
Pharm		 90-Day
Mail
Order		 Drug
Usage
Mgmt
EMBEDA ER 20-0.8 MG CAPSULE   3 Preferred Brand $27.00$67.50Q:60
/30Days
EMBEDA ER 30-1.2 MG CAPSULE   3 Preferred Brand $27.00$67.50Q:60
/30Days
EMBEDA ER 50-2 MG CAPSULE   3 Preferred Brand $27.00$67.50Q:60
/30Days
EMBEDA ER 60-2.4 MG CAPSULE   3 Preferred Brand $27.00$67.50Q:60
/30Days
EMBEDA ER 80-3.2 MG CAPSULE   3 Preferred Brand $27.00$67.50Q:60
/30Days
EMCYT 140MG CAPSULE   4 Non-Preferred Drug 40%40%None
EMEND 125 MG POWDER PACKET   4 Non-Preferred Drug 40%40%P
EMEND 40MG CAPSULE   4 Non-Preferred Drug 40%40%P
EMEND CAPSULES 125MG 6 BLPK   4 Non-Preferred Drug 40%40%P
EMEND CAPSULES 80MG 2 BLPK   4 Non-Preferred Drug 40%40%P
EMEND TRIFOLD PACK   4 Non-Preferred Drug 40%40%P
Drug Name Tier
Nbr.		 Tier
Description		 30-Day
Preferred
Pharm		 90-Day
Mail
Order		 Drug
Usage
Mgmt
Emoquette 6 BLISTER PACK per CARTON / 1 KIT per BLISTER PACK   3 Preferred Brand $27.00$67.50None
EMSAM TRANSDERMAL SYSTEM PATCHES 12MG/24H   5 Specialty Tier 33%N/AP Q:30
/30Days
EMSAM TRANSDERMAL SYSTEM PATCHES 6MG/24H   5 Specialty Tier 33%N/AP Q:30
/30Days
EMSAM TRANSDERMAL SYSTEM PATCHES 9MG/24H   5 Specialty Tier 33%N/AP Q:30
/30Days
EMTRIVA 10MG/ML SOLUTION   3 Preferred Brand $27.00$67.50None
EMTRIVA 200MG CAPSULE   3 Preferred Brand $27.00$67.50None
EMVERM 100 MG TABLET CHEW   4 Non-Preferred Drug 40%40%None
ENALAPRIL MALEATE 10MG TABLET (100 CT)   2 Generic $3.00$0.00None
ENALAPRIL MALEATE 2.5 MG TAB   2 Generic $3.00$0.00None
Enalapril Maleate 20mg/1 100 TABLET BOTTLE, PLASTIC   2 Generic $3.00$0.00None
ENALAPRIL MALEATE 5 MG TABLET   2 Generic $3.00$0.00None
Drug Name Tier
Nbr.		 Tier
Description		 30-Day
Preferred
Pharm		 90-Day
Mail
Order		 Drug
Usage
Mgmt
Enalapril Maleate and Hydrochlorothiazide 10; 25mg/1; mg/1 100 TABLET BOTTLE, PLASTIC   2 Generic $3.00$0.00None
ENALAPRIL MALEATE-HCTZ 5-12.5MG TABLET   2 Generic $3.00$0.00None
ENDOCET 10MG-325MG TABLET   3 Preferred Brand $27.00$67.50Q:360
/30Days
ENDOCET 5/325 TABLET   3 Preferred Brand $27.00$67.50Q:360
/30Days
ENDOCET 7.5-325MG TABLET   3 Preferred Brand $27.00$67.50Q:360
/30Days
ENGERIX B INJECTION   3 Preferred Brand $27.00$67.50P
ENGERIX-B 10MCG 10 X 0.5ML VIALSD   3 Preferred Brand $27.00$67.50P
ENGERIX-B 20 MCG/ML SYRN   3 Preferred Brand $27.00$67.50P
ENOXAPARIN 100 MG/ML SYRINGE   4 Non-Preferred Drug 40%40%None
ENOXAPARIN 120 MG/0.8 ML SYRINGE   4 Non-Preferred Drug 40%40%None
ENOXAPARIN 150 MG/ML SYRINGE   4 Non-Preferred Drug 40%40%None
Drug Name Tier
Nbr.		 Tier
Description		 30-Day
Preferred
Pharm		 90-Day
Mail
Order		 Drug
Usage
Mgmt
ENOXAPARIN 30 MG/0.3 ML SYRINGE   4 Non-Preferred Drug 40%40%None
ENOXAPARIN 300 MG/3 ML vial   4 Non-Preferred Drug 40%40%None
ENOXAPARIN 40 MG/0.4 ML SYRINGE   4 Non-Preferred Drug 40%40%None
ENOXAPARIN 60 MG/0.6 ML SYRINGE   4 Non-Preferred Drug 40%40%None
ENOXAPARIN 80 MG/0.8 ML SYRINGE   4 Non-Preferred Drug 40%40%None
ENTACAPONE 200 MG TABLET [Comtan Entacapone]   4 Non-Preferred Drug 40%40%None
ENTECAVIR 0.5 MG TABLET [Baraclude]   5 Specialty Tier 33%N/ANone
ENTECAVIR 1 MG TABLET [Baraclude]   5 Specialty Tier 33%N/ANone
ENTRESTO 24 MG-26 MG TABLET   3 Preferred Brand $27.00$67.50None
ENTRESTO 49 MG-51 MG TABLET   3 Preferred Brand $27.00$67.50None
ENTRESTO 97 MG-103 MG TABLET   3 Preferred Brand $27.00$67.50None
Drug Name Tier
Nbr.		 Tier
Description		 30-Day
Preferred
Pharm		 90-Day
Mail
Order		 Drug
Usage
Mgmt
ENULOSE 10 GM/15 ML SOLUTION   2 Generic $3.00$0.00None
EPIPEN 0.3MG AUTO-INJECTOR   3 Preferred Brand $27.00$67.50None
EPIPEN JR 0.15MG AUTO-INJCT   3 Preferred Brand $27.00$67.50None
Epirubicin 200 mg/100 ml vial   4 Non-Preferred Drug 40%40%P
EPITOL 200MG TABLET   4 Non-Preferred Drug 40%40%None
EPIVIR HBV 25MG/5ML TUBEX   4 Non-Preferred Drug 40%40%None
Eplerenone 25mg/1 90 TABLET BOTTLE   4 Non-Preferred Drug 40%40%None
Eplerenone 50mg/1 90 TABLET BOTTLE   4 Non-Preferred Drug 40%40%None
Ergotamine-caffeine 1-100mg tb   4 Non-Preferred Drug 40%40%None
ERIVEDGE 150 MG CAPSULE   5 Specialty Tier 33%N/AP
Errin 0.35 mg tablet   3 Preferred Brand $27.00$67.50None
Drug Name Tier
Nbr.		 Tier
Description		 30-Day
Preferred
Pharm		 90-Day
Mail
Order		 Drug
Usage
Mgmt
ERY 2% PADS 2% 60 PADS JAR   4 Non-Preferred Drug 40%40%None
ERY-TAB 500mg/1 100 TABLET, DELAYED RELEASE in 1 BOTTLE   4 Non-Preferred Drug 40%40%None
ERY-TAB TAB 250MG EC   4 Non-Preferred Drug 40%40%None
ERY-TAB TAB 333MG EC   4 Non-Preferred Drug 40%40%None
ERYTHROCIN 500MG ADDVNT VL   4 Non-Preferred Drug 40%40%None
ERYTHROCIN TAB 250MG   4 Non-Preferred Drug 40%40%None
Erythromycin 2% solution   3 Preferred Brand $27.00$67.50None
Erythromycin 20mg/g 1 TUBE per CARTON / 60 g in 1 TUBE   4 Non-Preferred Drug 40%40%None
ERYTHROMYCIN 500 MG FILMTAB   4 Non-Preferred Drug 40%40%None
ERYTHROMYCIN EC 250 MG CAP   4 Non-Preferred Drug 40%40%None
ERYTHROMYCIN ES 400 MG TAB   4 Non-Preferred Drug 40%40%None
Drug Name Tier
Nbr.		 Tier
Description		 30-Day
Preferred
Pharm		 90-Day
Mail
Order		 Drug
Usage
Mgmt
ERYTHROMYCIN OPHTHALMIC OINTMENT 0.5% 1 G BOX OF 50 TUBE   2 Generic $3.00$0.00None
ERYTHROMYCIN TAB 250MG BS   4 Non-Preferred Drug 40%40%None
ERYTHROMYCIN-BENZOYL PEROXIDE 3-5% GEL   4 Non-Preferred Drug 40%40%None
ESBRIET 267 MG CAPSULE   5 Specialty Tier 33%N/AP
ESBRIET 267 MG TABLET   5 Specialty Tier 33%N/AP
ESBRIET 801 MG TABLET   5 Specialty Tier 33%N/AP
ESCITALOPRAM 10 MG TABLET [Lexapro]   2 Generic $3.00$0.00None
ESCITALOPRAM 20 MG TABLET [Lexapro]   2 Generic $3.00$0.00None
ESCITALOPRAM 5 MG TABLET [Lexapro]   2 Generic $3.00$0.00None
ESCITALOPRAM OXALATE 5 MG/5 ML [Lexapro]   4 Non-Preferred Drug 40%40%None
ESOMEPRAZOLE DR 49.3 MG CAPSULE [Nexium]   3 Preferred Brand $27.00$67.50None
Drug Name Tier
Nbr.		 Tier
Description		 30-Day
Preferred
Pharm		 90-Day
Mail
Order		 Drug
Usage
Mgmt
ESOMEPRAZOLE MAG DR 20 MG CAPSULE [Nexium]   3 Preferred Brand $27.00$67.50None
ESOMEPRAZOLE SODIUM 20 MG VIAL [Nexium]   4 Non-Preferred Drug 40%40%None
ESOMEPRAZOLE SODIUM 40 MG VIAL [Nexium]   4 Non-Preferred Drug 40%40%None
ESTRACE VAG CREAM 0.1MG/GM   4 Non-Preferred Drug 40%40%None
ESTRADIOL 0.5MG TABLET   3 Preferred Brand $27.00$67.50None
ESTRADIOL 2MG TABLET   3 Preferred Brand $27.00$67.50None
ESTRADIOL TABLET 1MG (500 CT)   3 Preferred Brand $27.00$67.50None
ESTRADIOL TDS 0.025 MG/DAY   4 Non-Preferred Drug 40%40%None
ESTRADIOL TDS 0.0375 MG/DAY   4 Non-Preferred Drug 40%40%None
ESTRADIOL TDS 0.05 MG/DAY   4 Non-Preferred Drug 40%40%None
ESTRADIOL TDS 0.06 MG/DAY   4 Non-Preferred Drug 40%40%None
Drug Name Tier
Nbr.		 Tier
Description		 30-Day
Preferred
Pharm		 90-Day
Mail
Order		 Drug
Usage
Mgmt
ESTRADIOL TDS 0.075 MG/DAY   4 Non-Preferred Drug 40%40%None
ESTRADIOL TDS 0.1 MG/DAY   4 Non-Preferred Drug 40%40%None
ESTRADIOL VALERATE 20mg/mL 1 VIAL, MULTI-DOSE per CARTON / 5 mL in 1 VIAL, MULTI-DOSE   3 Preferred Brand $27.00$67.50None
ESTRADIOL VALERATE 40mg/mL 1 VIAL, MULTI-DOSE per CARTON / 5 mL in 1 VIAL, MULTI-DOSE   3 Preferred Brand $27.00$67.50None
ETHAMBUTOL HCL 400 MG TABLET   4 Non-Preferred Drug 40%40%None
Ethambutol Hydrochloride 100mg/1   4 Non-Preferred Drug 40%40%None
ETHINYL ESTRADIOL 0.03 MG / LEVONORGESTREL 0.05 MG ORAL TABLET) / 10 (ETHINYL ESTRADIOL 0.03 MG 6   3 Preferred Brand $27.00$67.50None
ETHINYL ESTRADIOL 0.03 MG / NORGESTREL 0.3 MG ORAL TABLET/ 7 (INERT INGREDIENTS 1 MG ORAL TAB 21   3 Preferred Brand $27.00$67.50None
ETHOSUXIMIDE 250 MG CAPSULE   4 Non-Preferred Drug 40%40%None
ETHOSUXIMIDE 250MG/5ML SYRP   4 Non-Preferred Drug 40%40%None
ethynodiol-eth estra 1mg-50mcg [ZOVIA]   3 Preferred Brand $27.00$67.50None
Drug Name Tier
Nbr.		 Tier
Description		 30-Day
Preferred
Pharm		 90-Day
Mail
Order		 Drug
Usage
Mgmt
ETODOLAC 200MG CAPSULE   4 Non-Preferred Drug 40%40%None
Etodolac 300 mg capsule   4 Non-Preferred Drug 40%40%None
ETODOLAC 400 MG TABLET   4 Non-Preferred Drug 40%40%None
ETODOLAC 500 MG TABLET   4 Non-Preferred Drug 40%40%None
Etoposide 500 mg/25 ml vial   3 Preferred Brand $27.00$67.50P
Eurax Lotion and Cream 100mg/g 454 g in 1 BOTTLE   4 Non-Preferred Drug 40%40%None
Eurax Lotion and Cream 100mg/g 60 g in 1 TUBE   4 Non-Preferred Drug 40%40%None
EVOTAZ 300 MG-150 MG TABLET   5 Specialty Tier 33%N/ANone
EXELON 13.3 MG/24HR PATCH   3 Preferred Brand $27.00$67.50Q:30
/30Days
EXELON 4.6MG/24HR PATCH TRANSDERMAL 24 HOURS   3 Preferred Brand $27.00$67.50Q:30
/30Days
EXELON 9.5MG/24HR PATCH TRANSDERMAL 24 HOURS   3 Preferred Brand $27.00$67.50Q:30
/30Days
Drug Name Tier
Nbr.		 Tier
Description		 30-Day
Preferred
Pharm		 90-Day
Mail
Order		 Drug
Usage
Mgmt
Exemestane 25mg/1 30 FILM COATED TABLETS in BOTTLE   4 Non-Preferred Drug 40%40%None
EXJADE 125MG TABLET   5 Specialty Tier 33%N/AP
EXJADE 250MG TABLET   5 Specialty Tier 33%N/AP
EXJADE 500MG TABLET   5 Specialty Tier 33%N/AP
Ezetimibe 10 mg tablet [Zetia]   3 Preferred Brand $27.00$67.50None

Chart Legend:

Below are a few notes to help you understand the above 2017 Medicare Part D SilverScript Plus (PDP) Plan Formulary.
  • Plan Name: This is the official Medicare Part D prescription drug plan name from the Centers for Medicare and Medicaid Services (CMS). The same Medicare Part D plan name generally has a different Plan ID in each state (or CMS Region).

  • Monthly Premium: This is the amount you must pay each month for this prescription drug plan. This monthly premium must be paid even if you are in the initial deductible phase or the coverage gap (donut hole) phase.

  • Deductible: If your Part D plan has an initial deductible, you are 100% responsible for your drug costs until your expenses exceed this value and you begin your Initial Coverage Phase. Many Medicare Part D plans use the standard $400 deductible as provided by CMS in their Standard plan design. Some Part D plan providers offer an initial deductible lower than the Standard deductible. Many prescription drug plans do not have a deductible (also called first dollar coverage or a $0 deductible), however the monthly premium for a plan with a $0 deductible may be slightly higher.

  • Qualifies for LIS: The Extra Help or Low Income Subsidy (LIS) Program.
    • Yes - This plan qualifies for the $0 Premium for those persons with a full LIS or Extra Help benefit. Persons on the LIS program who select a qualifying plan will also pay a $0 deductible, pay lower cost-sharing payments and have coverage through the Coverage Gap or Doughnut Hole.

    • No - This plan does not qualify for the $0 Premium for persons with the full LIS benefit.

  • Plan ID: This is the Medicare Part D prescription drug plan's unique ID.
  • Drug Tier Information - Drug Tiers are the logical grouping of prescription drugs on a Part D plan formulary. These fields represent the Tier (or drug list group) - for this particular medication - on this particular plan’s Formulary or Drug List.
    • Tier Number - This is the actual numerical tier level from the formulary. Most Part D plans have four (4) tiers 1=Preferred Generics, 2=Preferred Brands, 3=Non-preferred Brands and Generics, 4=Specialty Drugs.
    • Drug Description - This is the Medicare Part D plan’s description of this particular drug tier.
  • Cost Sharing - Copay / Coinsurance - These figures apply to the initial coverage phase of your plan. This is the phase after the initial deductible has been met and before you reach the Coverage Gap (Donut Hole). Plans often cover drugs in "tiers". Tiers are specific to the list of drugs covered by the plan. Plans may have several tiers, and the copay for a drug depends on the drug’s tier. The drug Tier is shown to the left of this column. These cost sharing figures DO NOT necessarily apply to the Coverage Gap. The plan may have a separate copay/coinsurance for the same drug while in the Coverage Gap. There are two figures shown under this "Cost Sharing" category:
    • Preferred Network Pharmacy - (Preferred Pharm) - This is the cost-share amount you would pay during the intial coverage phase for a 30-Day supply (until your total retail prescription drug costs reach $3700) at a "Preferred" network pharmacy. In most cases, the "Preferred" network and network pharmacy pricing are the same. However, for example on the 2017 Humana Walmart-Preferred Rx Plan the cost-sharing is much higher at a network pharmacy over a "Preferred" network pharmacy. "Preferred" network pharmacies for this plan include only Walmart, Sam’s Club and RightSource.
    • Mail Order - This is the cost-share amount you would pay during the initial coverage phase for a 90-Day supply if you purchased your medication through your plan’s preferred mail order partner(s).
  • Drug Utilization Management or Coverage Rules - (Drug Usage Mgmt) - This shows the plan requires drug utilization management controls for this particular medication.
    • None - This drug does not fall under any drug utilization management controls.
    • P - Prior Authorization -This drug is subject to prior authorization.
    • S - Step Therapy -This drug is subject to step therapy.
    • Q - Quantity Limits -This drug is subject to quantity limits. The actual quantity limit is shown as Q:Amount/Days. For Example: Q:6/28Days means the quantity limit is a quantity of 6 pills per 28 days. Q:90/365Days would mean that the plan limits this drug to 90 pills for the entire year.




(Chart Source: Centers for Medicare and Medicaid files: CMS Data September 2017 )

Please note: The above plan information comes from CMS. We make every attempt to keep our information up-to-date with plan/premium changes. However, the Medicare Part D plan data changes over time and we cannot guarantee the accuracy of this information. You should always verify cost and coverage information with your Part D plan provider.





 
 


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  • Q1Medicare®, Q1Rx®, and Q1Group® are registered Service Marks of Q1Group LLC and may not be used in any advertising, publicity, or for commercial purposes without the express authorization of Q1Group.
  • The Medicare Advantage and Medicare Part D prescription drug plan data on our site comes directly from Medicare and is subject to change.
  • Medicare has neither reviewed nor endorsed the information on our site.
  • We provide our Q1Medicare.com site for educational purposes and strive to present unbiased and accurate information. However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. For more information on your Medicare coverage, please be sure to seek legal, medical, pharmaceutical, or financial advice from a licensed professional or telephone Medicare at 1-800-633-4227.
  • We are an independent education, research, and technology company. We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. We are not compensated for Medicare plan enrollments. We do not sell leads or share your personal information.
  • Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. Our PDPCompare.com and MACompare.com provide highlights of annual plan benefit changes.
  • The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan.
  • Limitations, copayments, and restrictions may apply.
  • We make every effort to show all available Medicare Part D or Medicare Advantage plans in your service area. However, since our data is provided by Medicare, it is possible that this may not be a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.
    Statement required by Medicare:
    "We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options."
  • When enrolling in a Medicare Advantage plan, you must continue to pay your Medicare Part B premium.
  • Medicare beneficiaries with higher incomes may be required to pay both a Medicare Part B and Medicare Part D Income Related Monthly Adjustment Amount (IRMAA). Read more on IRMAA.
  • Medicare Advantage plans that include prescription drug coverage (MAPDs) are considered Medicare Part D plans and members with higher incomes may be subject to the Medicare Part D Income Related Monthly Adjustment Amount (IRMAA), just as members in stand-alone Part D plans. In certain situations, you can appeal IRMAA.
  • You must be enrolled in both Medicare Part A and Part B to enroll in a Medicare Advantage plan. Members may enroll in a Medicare Advantage plan only during specific times of the year. Contact the Medicare plan for more information.
  • If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or your state Medicaid Office.
  • Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next.
  • A Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. Providers who do not contract with the plan are not required to see you except in an emergency.
  • Disclaimer for Institutional Special Needs Plan (SNP): This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care and resides in a nursing home.
  • Disclaimer for Dual Eligible (Medicare/Medicaid) Special Needs Plan (SNP): This plan is available to anyone who has both Medical Assistance from the State and Medicare. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.
  • Disclaimer for Chronic Condition Special Needs Plan (SNP): This plan is available to anyone with Medicare who has been diagnosed with the plan specific Chronic Condition.
  • Medicare MSA Plans combine a high deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). The plan deposits money from Medicare into the account. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins.
  • Medicare MSA Plans do not cover prescription drugs. If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D prescription drug plan
  • There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. Those who disenroll during the calendar year will owe a portion of the account deposit back to the plan. Contact the plan provider for additional information.
  • Medicare beneficiaries may enroll through the CMS Medicare Online Enrollment Center located at www.medicare.gov.
  • Medicare beneficiaries can file a complaint with the Centers for Medicare & Medicaid Services by calling 1-800-MEDICARE 24 hours a day/7 days or using the medicare.gov site. Beneficiaries can appoint a representative by submitting CMS Form-1696.
.