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.
2014 Medicare Prescription Supplement Plan Details
Express Scripts Medicare - Choice (PDP)
|Provider:||Express Scripts Medicare|
|Monthly Drug Premium:||$49.60|
|Tiers with No Deductible:||0|
|Initial Coverage Limit:||$2850|
|Gap Coverage:||No Gap Coverage|
Deductible and Premium
The Express Scripts Medicare - Choice (PDP) plan has a monthly drug premium of $49.60 and a $0.00 drug deductible. This Express Scripts Medicare plan offers a $34.80 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 $14.80 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 $49.60. 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 $18.40 premium obligation if you receive a full low-income subsidy (LIS) assistance. And the payment is $26.20 for 75% low income subsidy $34.00 for 50% and $41.80 for 25%.
|Part D Basic Premium:||$34.80|
|Benchmark:||not below the regional benchmark|
|Part D Supplemental Premium||$14.80|
|Benefit Type:||Enhanced Alternative|
|Total Part D Premium:||$49.60|
|$0 Premium with Full LIS:||No|
|Full LIS Premium:||$18.40|
|75% LIS Premium:||$26.20|
|50% LIS Premium:||$34.00|
|25% LIS Premium:||$41.80|
In 2014 once you and your plan provider have spent $2,850 on covered drugs. (combined amount plus your deductible) You will be in the coverage gap. (AKA "donut hole") You will be require to pay 47.5% of the plans cost for covered brand-name prescription drugs and 72% of the cost for generic drugs unless your plan offers additional coverage. This Express Scripts Medicare plan covers No Gap Coverage through the gap. No Gap Coverage means 0% of formulary drugs are covered through the gap or 15 or less brand name products are covered through the gap.
Star Ratings for Express Scripts Medicare - Choice (PDP) S5660
|2014 Overall Rating|
|Members Choosing to Leave Plan|
|Rating of Drug Plan|
|Getting Needed Meds|
|Access And Performance|
|High Risk Medication|
|Adherence for Diabetes|
|Adherence for Hypertension|
|Adherence for Cholesterol|
Plans as of September 3, 2013.
Plans are subject to change as contracts are finalized.
Includes 2014 approved contracts/plans. Employer sponsored 800 series plans and plans under sanction are excluded.
Star Rating as of September 27, 2013.
For More Information on Ratings Please See the CMS Tech Notes Here.