2021 Express Scripts Medicare - Value (PDP) S5660-127 By Express Scripts Medicare

2021 Express Scripts Medicare - Value (PDP) By Express Scripts Medicare



Express Scripts Medicare - Value (PDP) is a Basic 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 - Value (PDP) plan has a monthly drug premium of $49.70 and a $445.0 drug deductible.



S5660-127 Part-D Summary of Bennefits

Plan Name:
Express Scripts Medicare - Value (PDP)
Provider: Express Scripts Medicare
Plan ID:
S5660-127
Plan Year:2021
State: Iowa
Minnesota
Montana
Nebraska
North Dakota
South Dakota
Wyoming
Benefit Type: Basic
Monthly Drug Premium: $49.70
Drug Deductible: $445.0
Tiers with No Deductible: 1
Gap Coverage: No
National Plan: Yes
Similar Plan: S5660-128


Deductible and Premium for Express Scripts Medicare - Value (PDP)

The Express Scripts Medicare - Value (PDP) plan has a monthly drug premium of $49.70 and a $445.0 drug deductible. This Express Scripts Medicare plan offers a $49.70 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 $- 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 $49.70. 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: $49.70
Benchmark: not below the regional benchmark
Part D Supplemental Premium $-
Benefit Type: Basic Alternative
Total Part D Premium: $49.70


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 - Value (PDP) medicare insurance plan offers a $11.70 premium obligation if you receive a full low-income subsidy (LIS) assistance. And the payment is $21.20 for 75% low income subsidy $30.70 for 50% and $40.20 for 25%.



$0 Premium with Full LIS: No
Full LIS Premium: $11.70
75% LIS Premium: $21.20
50% LIS Premium: $30.70
25% LIS Premium: $40.20


S5660-127 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 not offer additional coverage through the gap. If you are looking for additional health coverage you can see the Iowa Medigap Plans here.



S5660-127 Formulary or Drug Prices

Express Scripts Medicare - Value (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.

Drug Tier Copay
Preferred
Pharmacy
Copay
Nonpreferred
Pharmacy
Tier 1 $1 $19
Tier 2 $3 $20
Tier 3 $41 $47
Tier 4 50% 50%
Tier 5 25% 25%
Tier 6 $0 $5
*Initial Coverage Phase and 30 day supply





Express Scripts Medicare - Value (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

Total Rating
Rating of Drug Plan
Getting Needed Prescription Drugs


Drug Safety and Accuracy of Drug Pricing

Total Rating
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

Total Rating
Complaints about the Drug Plan
Members Choosing to Leave the Plan
Drug Plan Quality Improvement


Express Scripts Medicare - Value (PDP) Drug Plan Customer Service Ratings

Total Rating
Call Center, TTY, Foreign Language
Appeals Auto Forward
Appeals Upheld


Source: CMS.
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.

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