Plan Basics
Contract Year 2020
Medicare Type Medicare Prescription Drug Plan (Part D)
CMS Plan ID S6946-031-000
Plan Organization Clear Spring Health
Plan Type Medicare Prescription Drug Plan
Plan Name Clear Spring Health Premier Rx (PDP)
Plan Organization Type PDP
Drugs Covered Prescription Drugs are covered by the prescription drug plan
Doctors Choice Plan Doctors for Most Services
Benefit Type Enhanced
Special Needs Plan No
Overall Star Rating Plan too new to be measured
Plan Cost Sharing
Premium $15.60
Monthly Part D Basic Premium $-$0.60
Monthly Part D Supplemental Premium $16.20
Monthly Part D Total Premium $15.60
Monthly Part D Premium Full Assistance $15.60
Monthly Part D Premium 75% Assistance $15.60
Monthly Part D Premium 50% Assistance $15.60
Monthly Part D Premium 25% Assistance $15.60
Part D Drug Deductible $435.00
Annual Drug Deductible $435.00
Tiers Excluded From Deductible 1
Part D Initial Coverage Limit $4020.00
Part D Catastrophic Coverage Threshold $6350.00
Gap Coverage No
Formulary Website Formulary Link
Official Medicare Contact
Medicare Phone 1-800-MEDICARE (1-800-633-4227)
Medicare TTY User 1-877-486-2048

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