SilverScript Medicare Part D Drug Plans Review

In this Guide...

SilverScript Medicare plans are the most popular Medicare Part D prescription drug plans in the country. Our review details how much SilverScript drug plans cost, how highly they’re rated by Medicare and what you need to do to enroll if you’re eligible.

SilverScript Medicare plans are Medicare Part D prescription drug plans sold by Aetna, a CVS Health company. 

SilverScript Medicare Part D plans cover prescription drug costs, which is an area of health care not typically covered by Original Medicare (Part A and Part B). Medicare drug coverage may be provided as a standalone Part D plan (PDP), or it may be provided as part of a Medicare Advantage plan that includes drug coverage (also called a Medicare Advantage Prescription Drug plan, or MA-PD). 

The SilverScript family includes several distinct plans. 

SilverScript was the only Medicare Part D prescription drug plan serving over half a million beneficiaries to earn a 4 out of 5 Star Rating from Medicare in 2020.1

1
SilverScript Medicare Drug Plans

 

SilverScript SmartRx (PDP)

SilverScript Choice (PDP)

SilverScript Plus (PDP)*

Average monthly premium

$7.15

$28.49 (as low as $0 if you receive Extra Help)

$69.52

Deductible

Tier 1 drugs: $0

Tier 1 / Tier 2 drugs: $0

$0 on all tiers


* SilverScript Plus PDP is not available in Alaska

SilverScript SmartRX (PDP)

The SmartRX plan is the SilverScript Part D plan with the lowest monthly premiums. The plan comes with an average monthly premium of just $7.15 and has no deductible or copayment for Tier 1 drugs, which typically include most preferred generic drugs. You can even get a 90-day supply of Tier 1 drugs for no copayment. Tier 2 drugs come with a $19 copayment. 

According to the Kaiser Family Foundation, the SilverScriptRx plan has the lowest monthly premium of all Part D plans in the country for 2021.

SilverScript Choice (PDP)

The SilverScript Choice plan offers average premiums of $28.49 per month, a $0 deductible for Tier 1 and Tier 2 drugs and no copayments for Tier 1 medications. Tier 2 drug copayments are just $5 under this plan. As with the SmartRx Part D plan, you can get a 90-day supply of Tier 1 drugs with no copayment. 

The SilverScript Choice plan accounted for the greatest share of 2021 enrollment among Part D plans that are offered nationwide. Nearly 1 out of every 5 Part D beneficiaries in the country are enrolled in the Silverscript Choice plan.1

SilverScript Plus (PDP)

SilverScript Plus offers monthly premiums that average $69.52 per month, but the plan includes a $0 deductible for all drug tiers, a $0 copayment for Tier 1 drugs and $2 copayments for Tier 2 drugs.    

90-day supplies of Tier 1 and Tier 2 drugs are available with no copaymen,t and the plan includes additional gap coverage for Tier 1 and Tier 2 drugs. 

These plans also include Medicare donut hole gap coverage

2
SilverScript Medicare Plan Formulary and the Donut Hole Coverage Gap

SilverScript Medicare Part D plans use the Aetna Medicare drug formulary, which is a list of drugs covered by the plan. Drugs are separated into different tiers, with common generic drugs typically being in Tier 1, and more expensive brand name drugs being in Tier 3 or part of a higher specialty drug tier. 

Part D plans require a monthly premium, and higher income earners may be charged a higher premium. This higher monthly rate is called the Income-Related Medicare Adjusted Amount (IRMAA).

Many Part D plans have annual deductibles and copayments. Deductibles are capped at $445 for the year in 2021, and some Part D plans do not contain any deductible at all.  

Your costs in a Medicare Part D plan are staggered into different phases. The deductible phase begins at the start of the plan year and includes all of your covered Medicare drug spending up until your deductible amount. 

The initial coverage phase begins once you have reached your deductible (or begins right away for plans with no deductible). During this phase, you will make copayments for prescription drugs and refills. 

The coverage gap (often called the Medicare donut hole) begins once you and your plan have combined to spend $4,130 on covered drugs in 2021. Your coverage may be limited during the coverage gap, and you may be required to make increased copayments or coinsurance. You won’t be responsible for paying more than 25% of your plan’s cost for brand name and generic drugs while you’re in the donut hole. 

Lastly, catastrophic coverage begins once your total out-of-pocket drug spending reaches $6,550 and you leave the donut hole. Once you reach this phase, your plan will cover approximately 95% of your remaining drugs costs for the rest of the year. 

3
Pharmacies and Providers Who Accept SilverScript Medicare Plans

SilverScript Medicare Part D plans must be used within a network of participating pharmacies. Because SilverScript is part of the CVS family, these plans may be used at thousands of CVS locations all over the U.S., in addition to other participating pharmacy chains. 

You can search for pharmacies near you that accept SilverScript Part D plans from Aetna.

CVS Specialty Pharmacy

SilverScript Part D plans may be used with the CVS Specialty Pharmacy. This online pharmacy focuses on medications that are not typically available at brick-and-mortar retail pharmacies. 

The Specialty Pharmacy offers fast and no-cost delivery of your drugs and supplies right to your doorstep. In addition to medications, you may order injection supplies, bandages and more. 

4
How to Enroll in a SilverScript Medicare Part D Plan

Medicare has some rules about when you may and may not enroll in a Part D plan, and these will also apply to any SilverScript plan. 

There are generally 3 times at which you may enroll in a Medicare Part D plan. 

  1. Initial Enrollment Period (IEP)
    Your IEP begins three months before your 65th birthday, includes the month of your birthday and continues for three additional months. During this seven-month period, you can sign up for Medicare Part A and/or Part B as well as a Medicare Advantage plan with drug coverage or a standalone Part D plan.

  2. Fall Medicare Open Enrollment Period (also called the Annual Enrollment Period (AEP)
    The fall Medicare Open Enrollment Period lasts from Oct. 15 to Dec. 7 every year. During this period, you can enroll in a Part D plan, or you can switch from one Part D plan to another. You can also enroll in or switch Medicare Advantage plans, or you could drop your Medicare Advantage plan and return to Original Medicare.

  3. Special Enrollment Period (SEP)
    A Medicare Special Enrollment Period can be granted on a case-by-case basis throughout the year to individuals in specific circumstances. Your individual circumstance will affect what you can do during your Special Enrollment Period and how long the period will last.

Be sure to consult our Prescription Drug Cost Assistance Guide for additional ways to save money on prescription drugs.

You can also compare Medicare Part D plans and Medicare Advantage prescription drug plans online for free, with no obligation to enroll. Call to speak with a licensed insurance agent if you'd like help comparing plans and enrolling.

1 Every year, Medicare evaluates plans based on a 5-star rating system.

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