2023 Clear Spring Health Value Rx (PDP) By Clear Spring Health



Clear Spring Health Value Rx (PDP) S6946-016 is a Actuarially Equivalent Standard Medicare (Part-D) Prescription Drug Plan by Clear Spring Health. 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 Clear Spring Health Value Rx (PDP) plan has a monthly drug premium of $24.90 and a $505.00 drug deductible.



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S6946-016 Part-D Summary of Benefits

Plan Name:Clear Spring Health Value Rx (PDP)
Provider:Clear Spring Health
Plan ID:S6946-016
Plan Year:2023
State: Arkansas

Benefit Type:Basic
Monthly Drug Premium:$24.90
Drug Deductible: $505.00
Tiers with No Deductible:0
Gap Coverage:No
National Plan:No
Similar Plan:S6946-017


Deductible and Premium for Clear Spring Health Value Rx (PDP)

The Clear Spring Health Value Rx (PDP) plan has a monthly drug premium of $24.90 and a $505.00 drug deductible. This Clear Spring Health plan offers a $24.90 Part D Basic Premium that is 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 Clear Spring Health above and beyond the standard PDP benefits. This can include additional help in the gap, lower co-payments and coverage of non-Part D drugs. The Part D Total Premium is $24.90. The Part D Total Premium is the combined total of the supplemental and basic premiums for some plans this amount can be lower due to negative premiums.



Part D Basic Premium:$24.90
Benchmark:below the regional benchmark
Part D Supplemental Premium$-
Benefit Type:Actuarially Equivalent Standard
Total Part D Premium:$24.90


Clear Spring Health Premium Assistance

The Low Income Subsidy (LIS) helps seniors with Medicare pay for prescription drugs, and lowers the costs of Medicare prescription drug coverage. Depending on your income level you may be eligible for full 75%, 50%, 25% premium assistance. The Clear Spring Health Value Rx (PDP) medicare insurance plan offers a $0 premium obligation if you receive a full low-income subsidy (LIS) assistance. And the payment is $6.20 for 75% low income subsidy $12.40 for 50% and $18.70 for 25%.



$0 Premium with Full LIS:Yes
Full LIS Premium:$0
75% LIS Premium:$6.20
50% LIS Premium:$12.40
25% LIS Premium:$18.70


S6946-016 Gap Coverage

In 2023 once you and your plan provider have spent $4660 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 Clear Spring Health plan does not offer additional coverage through the gap.



S6946-016 Formulary or Drug Prices

Clear Spring Health Value Rx (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 $6
Tier 2 $3 $8
Tier 3 $42 $47
Tier 4 39% 39%
Tier 5 25% 25%
The complete Clear Spring Health Value Rx (PDP) Formulary.
*Initial Coverage Phase and 30 day supply





Clear Spring Health Value Rx (PDP) Plan Reviews

2022 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


Clear Spring Health Value Rx (PDP) Drug Plan Customer Service Ratings

Total Rating
Call Center, TTY, Foreign Language


Last updated on
Source: CMS.gov
For More Information on Ratings Please See the CMS Tech Notes.

Plans as of October 1, 2022.
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.

The Humana Prescription Drug Plan (PDP) pharmacy network includes limited lower-cost, preferred pharmacies in urban areas of AR, CT, DE, IA, IN, KY, ME, MI, MN, MO, MS, ND, NY, OH, PR, RI, SD, TN, VT, WI, WV; suburban areas of CT, HI, MA, ME, MI, MT, ND, NJ, NY, OH, PA, PR, RI, WV; and rural areas of IA, MN, MT, ND, NE, SD, VT, WY. There are an extremely limited number of preferred cost share pharmacies in urban areas in the following states: AR, DE, ME, MI, MN, MS, ND, NY, OH, RI, and SD; suburban areas of MT and ND; and rural areas of ND. The lower costs advertised in our plan materials for these pharmacies may not be available at the pharmacy you use. For up-to-date information about our network pharmacies, including whether there are any lower-cost preferred pharmacies in your area, please call Customer Care at 1-800-281-6918 (TTY: 711) or consult the online pharmacy directory at Humana.com.

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Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options. Enrollment depends on the plan’s contract renewal.

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