HealthChoice SilverScript High and Low Medicare Supplement plans offer the same Medicare supplement medical benefits for both plans. The difference in the high and low plans is in the pharmacy coverage.
The HealthChoice pharmacy benefit manager, SilverScript, is contracted with the Centers for Medicare & Medicaid Services (CMS) to provide Medicare Part D Prescription Drug benefits. These Part D benefits are available through the HealthChoice SilverScript High and Low Option Medicare Supplement Plans. The HealthChoice Pharmacy Network includes more than 68,000 pharmacies nationwide.
| HealthChoice SilverScript High Option with Part D | HealthChoice SilverScript Low Option with Part D |
|---|---|
| Pharmacy Deductible | Pharmacy Deductible |
| You pay the first $100 in medication costs. | You pay the first $445 in medication costs |
| Initial Coverage Limit | Initial Coverage Limit |
Generic (Tier 1) Drugs Up to $10 copay Preferred (Tier 2) Drugs |
After the deductible, you and HealthChoice share prescription drug costs You pay 25% ($921.25) and HealthChoice pays 75% ($2,763.75) until total drug spending reaches $4,130. |
| Coverage Gap | Coverage Gap |
| NONE | You pay 100% of your prescription drug costs at discounted rates – 25% of the cost of generic drugs and 25% of the cost of brand-name drugs. What you pay for brand-name drugs plus the 70%manufacturer discount applies to your out-of-pocket to get out of the coverage gap. For generic drugs, only what you pay applies. |
| Catastrophic Coverage | Catastrophic Coverage |
| Once you reach the $6,550 out-of-pocket maximum, you pay $0 for covered prescription drugs purchased at network pharmacies for the remainder of the calendar year. | Once you reach the $6,550 out-of-pocket maximum, you pay $0 for covered prescription drugs purchased at network pharmacies for the remainder of the calendar year. |
