2021 Express Scripts Medicare - Choice (PDP) By Express Scripts Medicare
Express Scripts Medicare - Choice (PDP) is a Enhanced Alternative 2021 Medicare (Part-D) Prescription Plan 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 $87.60 and a $100.0 drug deductible.
S5983-006 Part-D Summary of Bennefits
Express Scripts Medicare - Choice (PDP)
|Provider:||Express Scripts Medicare|
|Monthly Drug Premium:||$87.60|
|Tiers with No Deductible:||1|
Deductible and Premium for Express Scripts Medicare - Choice (PDP)
The Express Scripts Medicare - Choice (PDP) plan has a monthly drug premium of $87.60 and a $100.0 drug deductible. This Express Scripts Medicare plan offers a $2.10 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 $85.50 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 $87.60. 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.
|Part D Basic Premium:||$2.10|
|Benchmark:||not below the regional benchmark|
|Part D Supplemental Premium||$85.50|
|Benefit Type:||Enhanced Alternative|
|Total Part D Premium:||$87.60|
Express Scripts Medicare Premium Assistance
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 $85.50 premium obligation if you receive a full low-income subsidy (LIS) assistance. And the payment is $86.00 for 75% low income subsidy $86.50 for 50% and $87.10 for 25%.
|$0 Premium with Full LIS:||No|
|Full LIS Premium:||$85.50|
|75% LIS Premium:||$86.00|
|50% LIS Premium:||$86.50|
|25% LIS Premium:||$87.10|
S5983-006 Gap Coverage
In 2021 once you and your plan provider have spent $4130 on covered drugs. (combined amount plus your deductible) You will be in the coverage gap. (AKA "donut hole") You will still receive a 75% discount on covered brand-name drugs and a discount on generic drugs. Once you reach the coverage gap you will pay 25% of the plans cost for covered brand-name prescription drugs and 25% on generic drugs unless your plan offers additional coverage. This Express Scripts Medicare plan does offer additional coverage through the gap. If you are looking for additional health coverage you can see the New York City Medigap Plans here.
S5983-006 Formulary or Drug Prices
Express Scripts Medicare - Choice (PDP) formulary is divided into tiers or levels of coverage based on usage and according to the medication costs. Each tier will have a defined copay that you must pay to receive the drug. Drugs in lower tiers will usually cost less than those in higher tiers. By reviewing different Medicare Drug formularies, you can pick a Medicare Advantage plan that covers your medications. Additionally, you can choose a plan that has your drugs listed at a lower price.
Express Scripts Medicare - Choice (PDP) Plan Reviews
|2020 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|
|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
|Call Center, TTY, Foreign Language|
|Appeals Auto Forward|
Plans as of September 9, 2020.
Notes: Data are subject to change. All contracts for 2020 have been not finalized. For 2020, 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 2020 approved contracts/plans. Employer sponsored 800 series plans and plans under sanction are excluded.