Aetna’s SilverScript is a popular Part D prescription drug plan among Medicare beneficiaries. Is it so popular that it’s the best plan on the market? If so, what makes it so great?
These are all good questions that many of our clients have. SilverScript is a popular choice, but that may not mean it’s the best one for you. In order to make that decision, you’ll need to understand how drug plans work and which aspects of each plan you’ll need to consider.
The Structure of Part D Plans
Medicare Part D is made up of prescription drug plans that are offered by private insurance companies. These may come in the form of a stand-alone plan or as part of a Medicare Advantage plan.
Drug Formularies
Each Part D plan has a drug formulary. The formulary is a list of prescriptions that are covered under the plan. The medications are then split into tiers. Depending on the plan, it may have three, four, or five different tiers. No matter how many tiers it has, they work in a similar fashion. Prescriptions in the lowest tier are common, generic medications that many people use. This includes medications for high cholesterol, high blood pressure, etc. These are also the least expensive. Medications in the higher tiers are usually specialty, name-brand drugs. As you can probably guess, these medications are the most expensive.
Part D Pharmacy Networks
You have probably heard of providers who are “in” or “out” of a network. This concept somewhat applies to Part D plans and which pharmacies they work with. If a pharmacy is a “preferred” pharmacy with the plan, that means the individual’s out-of-pocket cost will be less. You’ll pay more if you have your medications filled at a “standard” pharmacy, and you’ll pay even more if you use a pharmacy that does not work with the plan at all.
- This concept somewhat applies to Part D plans and which pharmacies they work with.
Part D Deductibles
Most drug plans also include an annual deductible. The standard deductible in 2022 is $480, and most plans do adopt this standard. (It is also the maximum deductible that any plan can have.) Many of the plans do not apply the deductible to Tier One prescriptions. Some even allow the Tier Two medications to bypass the annual deductible.
Part D Premiums
Lastly, each Part D plan will have a monthly premium. The premium will vary depending on the plan and the insurance company. If you have incurred a Part D penalty, that penalty will be added to your monthly premium.
Part D Plans and the Annual Enrollment Period
One of the most important things to understand about Part D plans is that they will change every year. For this reason, no Medicare beneficiary should ignore the Annual Enrollment Period, which happens every fall from October 15 – December 7.
Prior to the AEP, Part D plan members will receive an Annual Notice of Change (ANOC) from their current Part D insurance carrier. This document will review any and all changes that will be made to your current plan in the upcoming year. Changes may include changes in your premium, deductible, pharmacy network, and even changes to the drug formulary. It’s possible that a medication you take will not be covered in the new year or that the medication will be moved to a higher (more expensive) tier.
During the Annual Enrollment Period, you can choose a new plan for the next year. You should have a licensed agent review your current prescriptions and find out if there is a different plan that would be better for you. Changes you make during the AEP will go into effect on January 1 of the new year.
What plans does Aetna SilverScript offer in 2022?
SilverScript, which is run by Aetna, has three plans available for 2022. They offer SilverScript Choice, SilverScript Plus, and SilverScript SmartRx.
All of these plans are great options, but as we’ve said, that really depends on what medications you are taking, which pharmacy you prefer, and where you live. Some of the plans offer coverage for name-brand medications, and others do not. Some have a larger number of pharmacies they work with, while others only offer coverage at a select few.
All of the SilverScript prescription drug plans offer mail orders as an option, so members can skip trips to the pharmacy.
One of the SilverScript drug plans may be a great option for you. Or, maybe not. The easiest way to find out is to work with one of our licensed agents. We will look at your current medications and find the plan that will give you the most coverage with the least out-of-pocket expense. Give our office a call today and schedule your free consultation!