Express Scripts Medicare - Choice (PDP) By Express Scripts Medicare
Express Scripts Medicare - Choice (PDP) is a Enhanced Alternative Medicare Prescription Drug Plan (PART D) by Express Scripts Medicare. Stand-alone plans offer additional prescription drug coverage only and are an option if you are on Original Medicare insurance or you have a Medicare health plan that does not include Part D coverage. The Express Scripts Medicare - Choice (PDP) plan has a monthly drug premium of $85.50 and a $350.00 drug deductible.
2017 Medicare Prescription Supplement Plan Details
Express Scripts Medicare - Choice (PDP)
|Provider:||Express Scripts Medicare|
|Monthly Drug Premium:||$85.50|
|Tiers with No Deductible:||1|
|Initial Coverage Limit:||$3700|
Deductible and Premium
The Express Scripts Medicare - Choice (PDP) plan has a monthly drug premium of $85.50 and a $350.00 drug deductible. This Express Scripts Medicare plan offers a $72.00 Part D Basic Premium that is not below the regional benchmark. This covers the basic prescription benefit only and does not cover enhanced drug benefits such as medical benefits or hospital benefits. The Part D Supplemental Premium is $13.50 this Premium covers any enhanced plan benefits offered by Express Scripts Medicare above and beyond the standard PDP benefits. This can include additional coverage in the gap, lower co-payments and coverage of non-Part D drugs. The Part D Total Premium is $85.50. The Part D Total Premium is the addition of the supplemental and basic premiums for some plans this amount can be lower due to negative basic or supplemental premiums.
Depending on your income level you may be eligible for full 75%, 50%, 25% premium assistance. The Express Scripts Medicare - Choice (PDP) medicare insurance plan offers a $52.30 premium obligation if you receive a full low-income subsidy (LIS) assistance. And the payment is $60.60 for 75% low income subsidy $68.90 for 50% and $77.20 for 25%.
|Part D Basic Premium:||$72.00|
|Benchmark:||not below the regional benchmark|
|Part D Supplemental Premium||$13.50|
|Benefit Type:||Enhanced Alternative|
|Total Part D Premium:||$85.50|
|$0 Premium with Full LIS:||No|
|Full LIS Premium:||$52.30|
|75% LIS Premium:||$60.60|
|50% LIS Premium:||$68.90|
|25% LIS Premium:||$77.20|
In 2017 once you and your plan provider have spent $3700 on covered drugs. (combined amount plus your deductible) You will be in the coverage gap. (AKA "donut hole") You will still receive a 60% discount on brand-name drugs and a 49% discount on generic drugs. Once you reach the coverage gap you will pay 40% of the plans cost for covered brand-name prescription drugs and 51% on generic drugs unless your plan offers additional coverage. This Express Scripts Medicare plan does not offer additional coverage through the gap.
Ratings for Express Scripts Medicare - Choice (PDP) S5660
|2017 Overall Rating|
|Drug Plan Customer Service|
|Complaints and Changes in the Drug Plan|
|Member Experience with the Drug Plan|
|Drug Safety and Accuracy of Drug Pricing|
Member Experience with the Drug Plan
|Rating of Drug Plan|
|Getting Needed Prescription Drugs|
Drug Safety and Accuracy of Drug Pricing
|MPF Price Accuracy|
|High Risk Medication|
|Drug Adherence for Diabetes Medications|
|Drug Adherence for Hypertension (RAS antagonists)|
|Drug Adherence for Cholesterol (Statins)|
|MTM Program Completion Rate for CMR|
Ratings For Member Complaints and Changes in the Drug Plans Performance
|Complaints about the Drug Plan|
|Members Choosing to Leave the Plan|
|Drug Plan Quality Improvement|
Express Scripts Medicare - Choice (PDP) Drug Plan Customer Service ratings
|Appeals Auto Forward|
|Call Center, TTY, Foreign Language|
Plans as of September 6, 2016.
Star Rating as of September 26, 2016.
For More Information on Ratings Please See the CMS Tech Notes Here.
Notes: Data are subject to change. All contracts for 2017 have been not finalized. For 2017, enhanced alternative plans may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part
Includes 2017 approved contracts/plans. Employer sponsored 800 series plans and plans under sanction are excluded.