Clear Spring Health Premier Rx Part D Plan S6946-097 Details for Massachusetts
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Clear Spring Health Premier Rx is a 2025 Medicare Part D plan from Clear Spring Health that's available to people with Medicare Part A and/or Part B or a Medicare Advantage plan that does not include prescription drug plan benefits.
Clear Spring Health Premier Rx is a cost-sharing plan that has a $74.10 monthly premium, an initial coverage limit of $5,030, a $590.00 annual deductible, and an out-of-pocket threshold of $8,000. *This plan is rated 2 (Below Average) stars out of 5 stars by CMS.
See more Medicare Part D Plans in Massachusetts.
| Part D Plan Basics | |
|---|---|
| Plan ID: | S6946-097 |
| Plan Type: | PDP |
| Plan Year: | 2025 |
| Premium: | $74.10/mo |
| Deductible: | $590.00/yr |
| Benefit Type: | Enhanced |
| Low Income Subsidy: | Yes |
| Availability: | Massachusetts |
| Insured By: | Clear Spring Health |
Prescription Drug Plan Premium
Although Clear Spring Health Premier Rx 's monthly premium is bundled with the total plan cost, some plans have supplemental costs and/or offer low-income subsidy (LIS) assistance. The following table outlines the premium details of this Clear Spring Health plan.
| Basic Part D Premium: | $48.20 |
| Supplemental Part D Premium: | $25.90 |
| Total Part D Premium: | $74.10 |
| Low Income Premium Subsidy: | $52.52 |
| Low Income Premium Subsidy CMS Pays: | $48.20 |
| Low Income Subsidy Premium: | $25.90 |
The Social Security Extra Help page has more information about the Low-Income Subsidy (“Extra Help”) program.
Prescription Drug Plan Deductible
This plan's Medicare Part D annual deductible is $590.00. You must pay this amount at the pharmacy before Clear Spring Health begins paying its share
Prescription Drug Plan Out-of-Pocket Costs
In addition to the plan's monthly premium and deductible, Clear Spring Health Premier Rx has copayments (a fixed dollar amount) and/or coinsurances (a percentage amount) that you must pay when you pick up your prescriptions. The following table shows you those costs.
| Drug Tier | Retail | Mail Order | Out of Network |
|---|---|---|---|
| Preferred Generic | $0.00 | $10.00 | $10.00 |
| Generic* | $3.00 | $20.00 | $20.00 |
| Preferred Brand* | 15.00% | 20.00% | 20.00% |
| Non-Preferred Drug | 35.00% | 40.00% | 40.00% |
| Specialty Tier | 25.00% | 25.00% | 25.00% |
| *Deductible does not apply. | |||
CMS Rating Marks for Plan Year 2025
Each year the Centers for Medicare & Medicaid Services (CMS) rates drug plans (Part D) in four broad categories. We do not recommend joining a plan with an overall rating of less than 3.0. Here are the most recent CMS ratings for this 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 |
The true value of any Medicare Part D plan can only be judged by how well it covers your medications.
Contact Clear Spring Health
| Plan Website: | Clear Spring Health |
|---|---|
| Formulay Information: | Clear Spring Health Formulary Information |
| Pharmacy Information: | Clear Spring Health Pharmacy Information |
| Prospective Part D Members: | (877)248-6622 |
| Prospective Part D TTY Users: | 711 |
If you qualify for Original Medicare but have not yet enrolled or verified your enrollment status, you can do so on the Social Security Administration website. You can learn more about the Medicare Advantage program at www.medicare.gov.
Citations & References
- Clear Spring Health, "http://www.clearspringhealthcare.com", Last Accessed October 13, 2024
- Medicare.gov, "Drug coverage (part D)", Last Accessed March 2, 2024
- Benefits.gov, "Medicare Prescription Drug Plans", Last Accessed March 1, 2024
- Medicare.gov, "Medicare costs at a glance", Last Accessed March 11, 2024
- SSA.gov, "Apply for Medicare Part D Extra Help program", Last Accessed March 9, 2024
- CMS.gov, "Landscape Source Files", Last Accessed October 3, 2024
- CMS.gov, "Medicare Part C & D Performance", Last Accessed October 11, 2024
- CMS.gov, "Benefits Data", Last Accessed October 9, 2024
Plans Offered
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.