Clear Spring Health Premier Rx A 2025 Medicare Part D Plan (S6946-067)
Clear Spring Health Premier Rx A 2025 Medicare Part D Plan (S6946-067)
Welcome to the 2025 Clear Spring Health Premier Rx Medicare Part D plan guide. Here, you’ll find all the information you need, including plan benefits, costs, and star ratings. We’ve also included enrollment options to assist you in securing the right prescription drug coverage for you.
The Clear Spring Health Premier Rx plan provides valuable coverage for reducing your prescription drug costs, whether you're enrolled in Medicare Part A and/or Part B, or a Medicare Advantage plan without drug coverage.
| Clear Spring Health Premier Rx : Part D Plan Overview | |
|---|---|
| Part D Plan ID: | S6946-067 |
| Plan Year: | 2025 |
| Total Part D Premium: | $72.50 |
| Annual Deductible: | $590.00 |
| Part D Benefit Type: | Enhanced |
| No Deductible Drug Tier: | Yes |
| Low Income Subsidy: | Yes |
| Insured By: | Clear Spring Health |
| We're Here to Help You Enroll |
|---|
Breaking Down Medicare Part D Plan Costs
Clear Spring Health Premier Rx has various costs beyond just the monthly premium. From deductibles to copayments and coinsurance, it's essential to understand how these expenses work so you can effectively manage your prescription drug costs. The sections below break down each cost component to help you navigate these financial details with ease.
Monthly Premium Overview
The Clear Spring Health Premier Rx plan's monthly premium plays a significant role in determining your overall costs. Some plans may also include supplemental charges or offer Low-Income Subsidy (LIS) options. Below is a breakdown of the premium details for this 2025 plan from Clear Spring Health.
| Basic Part D Premium: | $47.00 |
| Supplemental Part D Premium: | $25.50 |
| Total Part D Premium: | $72.50 |
| Low Income Premium Subsidy: | $56.86 |
| Low Income Premium Subsidy CMS Pays: | $47.00 |
| Low Income Subsidy Premium: | $25.50 |
TIP: To learn more about the Low-Income Subsidy (LIS) program, also known as "Extra Help," and how it can assist with your prescription drug costs in New Jersey, visit the Social Security Extra Help page.
Understanding the Plan’s Deductible
This plan's Medicare Part D annual deductible is $590.00. You will need to pay this deductible amount before Clear Spring Health begins covering your prescription drug costs at the pharmacy.
Prescription Drug Plan Out-of-Pocket Costs
In addition to the monthly premium and deductible, you'll also be responsible for copayments (fixed amounts) and/or coinsurance (a percentage of the drug cost) under the Clear Spring Health Premier Rx plan. The following table details these out-of-pocket costs.
| Drug Tier | Retail | Mail Order | |
|---|---|---|---|
| Preferred Generic* | $0.00 | $10.00 | |
| Generic* | $3.00 | $20.00 | |
| Preferred Brand | 15.00% | 20.00% | |
| Non-Preferred Drug | 35.00% | 40.00% | |
| Specialty Tier | 25.00% | 25.00% | |
| *Deductible does not apply. | |||
How the CMS 5-Star Rating Works
Every year, the Centers for Medicare & Medicaid Services (CMS) rates Medicare Part D plans on a 5-star scale, with 5 stars representing excellent quality and performance. These ratings consider factors like customer service, member experience, and the safety of prescription drugs. A higher rating reflects better overall quality, helping you choose the best plan for your needs. The table below shows the CMS rating for the Clear Spring Health Premier Rx plan.
| CMS Measure | Star Rating |
|---|---|
| Overall Plan Rating | |
| Drug Plan Customer Service | Not enough data available |
| Complaints and Changes in the Drug Plan | |
| Member Experience with the Drug Plan | |
| Drug Safety and Accuracy of Drug Pricing |
When to Enroll in a Medicare Part D Plan
Knowing when to enroll in a Medicare Part D plan is crucial to ensuring you have the coverage you need. Below are the main enrollment periods:
- Initial Enrollment Period (IEP): This seven-month period begins three months before your 65th birthday month. Discover more about your Medicare Initial Enrollment Period.
- Annual Enrollment Period (AEP): Every year between October 15 and December 7, you can make changes to your Medicare Part D plan. Learn about the Annual Enrollment Period.
- Medicare Advantage Open Enrollment Period (MA-OEP): From January 1 to March 31, you can switch Medicare Advantage plans or return to Original Medicare, , so long as you are currently enrolled in a Medicare Advantage plan. Learn more about the MA Open Enrollment Period.
- Special Enrollment Period (SEP): Life events such as relocating or losing coverage can trigger a Special Enrollment Period, allowing changes outside the usual enrollment windows.
How to Enroll in Medicare Part D
There are several ways to enroll in Clear Spring Health Premier Rx or another Medicare Part D plan, allowing you to choose the method that works best for you:
- Online via MedicareEnrollment.com: Easily compare and enroll in plans by visiting MedicareEnrollment.com.
- Call HealthCompare: Get expert help from HealthCompare by calling 833-748-3201 (TTY 711). They can assist you in finding the right plan for your needs (Mon-Fri 5am-6pm, Sat 6am-5pm PST).
- Call 1-800-MEDICARE: For additional guidance, contact Medicare at 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.
- Call the Plan Directly: Alternatively, reach out to the plan directly using the contact information provided below.
Contact Clear Spring Health
| Website: | Clear Spring Health Plan Page |
|---|---|
| Formulary: | Clear Spring Health Formulary Page |
| Pharmacy: | Clear Spring Health Pharmacy Page |
| Prospective Part D Members: | (877)248-6622 |
| Prospective Part D TTY Users: | 711 |
Plans Offered Through Medicare.org
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Baylor Scott & White Health Plan, Capital Blue Cross, Cigna Healthcare, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, GlobalHealth, Health Care Service Corporation, Healthy Blue, HealthSun, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.
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