1. Healthcare

NEW FOR 2015
Lower Premiums
in most states.*
2015 Plan and Enrollment Guide
A helpful resource for choosing and enrolling in the SilverScript
Medicare Part D Prescription Drug Plan that’s right for you.
*Lower premiums do not apply in Alaska.
Y0080_12008_ACQ_2015 Approved
15-PG-CN
Your path to better health begins with
SilverScript
Questions about SilverScript?
Call us toll free at 1-866-552-6106,
24 hours a day, 7 days a week.
TTY users call 1-866-552-6288.
2
Learn more online at
www.silverscript.com
SilverScript is the Nation’s second largest1 stand-alone Medicare prescription
drug plan (PDP) sponsor. We cover more than 4 million2 members of all
incomes, backgrounds and lifestyles. At SilverScript, we believe you shouldn’t
have to sacrifice the prescription coverage you want for a plan you can afford.
Consider just a few of the reasons why millions2 of people trust
SilverScript for their prescription drug coverage:
1. Affordable SilverScript Choice (PDP) coverage
•$0 annual deductible3 (coverage begins with your first prescription)
•Premiums between $12.60 and $45.90
•The same low copays and coinsurance at any network pharmacy coast to coast
•Save money and time with 90-day prescriptions—in store or through the mail
2. Two extensive pharmacy networks that include:
•Most national pharmacy chains including CVS, Walgreens & Rite Aid
•Most mass retail and grocery store pharmacies including Walmart & Target
•Many community based, independent pharmacies
•More than 40,0004 preferred pharmacies in our SilverScript Plus (PDP) network
•Convenient access to CVS Caremark Mail Service Pharmacy with free standard5
delivery
for 90-day supply and you can choose to sign up for automated mail order delivery
3. Comprehensive prescription drug coverage
•A
formulary that covers more than 3,2506 brand, generic and specialty drugs often
prescribed for people with Medicare
4. US-based Customer Care and online support
•Round-the-clock Customer Care ready to assist you
•User-friendly website with numerous helpful tools and
resources
5. Added Value ExtraCare® Health Card
•SilverScript
membership offers you a complementary ExtraCare Health Card. This
value-added card features a healthy 20%7 discount on thousands of regularly priced
CVS/pharmacy Brand® health-related items at any of more than 7,6004 CVS/pharmacy
stores nationwide8 or online at www.cvs.com
How does SilverScript compare?
Use our Plan Comparison Aid on page 4 to compare Medicare Part D plans.
3
Plan Comparison Aid
Use this tool to compare Medicare Part D plans and find the one that is right
for you based on your individual needs. The four simple steps below will help
you compare coverage, pricing and overall plan value.
Step 1
List your prescription drugs here, as well as the dosage and frequency as shown
on the drug label.
Name of Prescription Drug
Dosage
Frequency
1.
2.
3.
4.
5.
Step 2
Here, list costs and coverage information for the Medicare Part D plans you are
considering. To find Medicare Part D plans in your area, see the Medicare contact
information below.
Annual
Deductible
Amount
1. Part D Plan Name:
$
$
2. Part D Plan Name:
$
$
3. Part D Plan Name:
$
$
Monthly
Premium
Number of
my drugs
covered
Copay for
30-Day
Supply
Copay for
90-Day
Supply
Copay in
Coverage
Gap
$
$
$
$
$
$
$
$
$
Is my
pharmacy in
network?
Note: Find the monthly premium for SilverScript plans in your state on pages 7 & 9.
Step 3
Compare each plan’s value using the information you entered above. Keep in
mind that an annual deductible is an out-of-pocket expense you will pay before
the plan begins to share the cost of your prescriptions. That isn’t a concern with
SilverScript Choice because it is a $0 deductible3 plan.
Step 4
When you’re ready to enroll in the plan that’s right for you, remember that
SilverScript offers you three ways to enroll. See the back cover of this guide
for more information.
How to Contact Medicare
Call 1-800-MEDICARE
(1-800-633-4227), 24 hours a
day, 7 days a week. TTY users
call 1-877-486-2048.
4
To comparison shop if you want
to see other non-SilverScript
plans visit Medicare online at
www.medicare.gov
Two Extensive Nationwide Pharmacy Networks
At home or traveling the U.S., it’s reassuring to know that we’re never far from
where you are.
SilverScript Choice Pharmacy Network­­—More than 57,0004 pharmacies,
one low copay
More than 57,000 pharmacies4 welcome your SilverScript Choice plan coverage. Each
pharmacy will fill your prescriptions for the same low copay at any of the familiar names you
see below and thousands more. You may also choose the convenience of CVS Caremark
Mail Service Pharmacy for standard delivery at no extra cost of 90-day supplies.
CVS Caremark
Mail Service pharmacy
Plus, thousands of community based, independent pharmacies.4
SilverScript Plus Pharmacy Network—More than 68,0004 standard
and preferred pharmacies
SilverScript Plus (PDP) members may use their benefit at more than 68,0004 pharmacies,
including the familiar names shown above and many more. More than 40,0004 pharmacies in
the nationwide SilverScript Plus network are preferred pharmacies, meaning members enjoy
the lowest copays and coinsurance at these pharmacies. Preferred pharmacies include
retail leaders like CVS/pharmacy, Walmart, Walgreens & Target, just to name a few; as
well as thousands of community based, independent pharmacies and CVS Caremark Mail
Service Pharmacy.
Locate any pharmacy in the SilverScript network
Call us toll free at 1-866-552-6106,
24 hours a day, 7 days a week. TTY
users call 1-866-552-6288.
Use our online
pharmacy locator at
www.silverscript.com
5
SilverScript
Choice
This $0 deductible9 plan combines affordable
premiums, low copays and the convenience of an
extensive, nationwide pharmacy network to offer
uncommon value for anyone who needs Medicare
prescription drug coverage. No deductible means
you could save hundreds of dollars in out-of-pocket
costs, and your plan shares the cost of your
prescriptions the very first day of coverage.
STAGE 1:
Annual Deductible
STAGE 2:
Initial Coverage
$0 Deductible
SilverScript Choice is a $0 deductible plan,† meaning
the Initial Coverage Stage begins the day your plan
takes effect.
Your copays ($) and coinsurance (%)
Standard CVS Caremark
Mail Service Pharmacy
Standard
Pharmacy
Drug Tiers
30-day
90-day
90-day
Tier 1† Generic Drugs
$7 – $10
$17.50 – $25
$17.50 – $25
$22 – $41
$55– $102.50
$55– $102.50
Tier 2† Preferred Brand Drugs
42%– 47%
Tier 3† Non-Preferred Brand Drugs
33%
Tier 4† Specialty Drugs
STAGE 3:
Coverage Gap (Donut Hole)
You leave the Initial Coverage Stage and enter the
Coverage Gap when you have reached $2,960 in total
yearly drug costs (not including monthly premiums).
Generic Drugs You pay 65% of the cost
Brand Drugs
STAGE 4:
Catastrophic Coverage
You pay 45% of the cost
You enter the Catastrophic Coverage Stage when you
have spent $4,700 out of pocket (not including monthly
premiums).
Generic Drugs You pay the greater of
5% coinsurance or $2.65 copay
All Other Drugs You pay the greater of
5% coinsurance or $6.60 copay
All Tiers may include generic and brand drugs. Alaska Choice Plan has a $320 deductible
and Stage 2 copays/coinsurance of $2 / 17% / 37% / 25% (Tiers 1-4). Call or visit the
SilverScript website for more information9.
†
6
Choice Plan Costs by State
Your premium may be lower if you qualify for Extra Help.
See page 11 for more information.
Your Monthly Tier 1
State Premium Copay
AK10 $45.90
$2
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
Tier 2
Tier 3
Copay Coinsurance
$21.80
$17.90
$18.70
$22.20
$24.20
$23.30
$7
$7
$9
$8
$8
$8
17%
$33
$33
$35
$41
$40
$27
$26.00
$26.00
$20.60
$20.00
$22.00
$26.10
$32.00
$21.70
$22.60
$25.00
$22.60
$21.30
$23.30
$26.00
$24.00
$25.40
$26.10
$24.10
$21.60
$7
$7
$8
$7
$10
$9
$8
$8
$7
$7
$7
$8
$8
$7
$7
$7
$9
$7
$7
$40
$40
$40
$35
$36
$22
$33
$37
$34
$36
$34
$29
$27
$40
$38
$40
$22
$31
$37
37%
47%
44%
46%
43%
45%
45%
46%
46%
42%
46%
45%
43%
42%
43%
45%
42%
45%
45%
45%
46%
43%
43%
43%
43%
47%
Tier 4 Coinsurance10
Your Monthly Tier 1
State Premium Copay
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Tier 2
Tier 3
Copay Coinsurance
$26.10
$23.10
$26.10
$26.10
$24.00
$30.40
$12.60
$9
$7
$9
$9
$7
$8
$8
$22
$37
$22
$22
$38
$34
$40
43%
47%
43%
43%
43%
47%
44%
$30.80
$25.70
$21.70
$23.10
$25.80
$22.00
$23.30
$25.00
$26.10
$21.80
$21.00
$32.00
$22.30
$23.30
$25.80
$27.10
$22.00
$26.10
$8
$7
$8
$7
$7
$7
$8
$8
$9
$7
$8
$8
$8
$8
$7
$8
$7
$9
$35
$34
$27
$33
$37
$32
$27
$34
$22
$33
$37
$33
$36
$27
$37
$26
$32
$22
45%
47%
46%
46%
43%
47%
45%
46%
43%
47%
47%
42%
45%
45%
43%
43%
47%
43%
33%
Questions about our plans or premiums?
Call SilverScript toll free at
1-866-552-6106, 24 hours
a day, 7 days a week. TTY users
call 1-866-552-6288.
For more plan and
premium information visit
www.silverscript.com
7
SilverScript
Plus
11
This enhanced plan is for people who take several
prescriptions and are likely to reach the Coverage
Gap. SilverScript Plus provides more coverage
for Tier 1 drugs in the Gap to help lower your
out-of-pocket costs.
STAGE 1:
Annual Deductible
STAGE 2:
Initial Coverage
$0 Deductible
SilverScript Plus is a $0 deductible plan, meaning
the Initial Coverage Stage begins the day your plan
takes effect.
Your copays ($) and coinsurance (%)
Preferred
Pharmacy
Drug Tiers
Standard
Pharmacy
Preferred
CVS Caremark Mail
Service Pharmacy
30-day
90-day
30-day
90-day
90-day
Tier 1† Generic Drugs
$0
$0
$7
$21
$0
Tier 2† Preferred Brand Drugs
$24
$60
$31
$93
$60
Tier 3† Non-Preferred Brand Drugs
40%
50%
33%
Tier 4† Specialty Drugs
STAGE 3:
Coverage Gap (Donut Hole)
40%
You leave the Initial Coverage Stage and enter the
Coverage Gap when you have reached $2,960 in total
yearly drug costs (not including monthly premiums).
30-day
90-day
30-day
90-day
90-day
No more than
Tier 1
Tiers 2, 3 and 4
$0
$21
$0
Generic Drugs You pay 65% of the cost
Brand Drugs
STAGE 4:
Catastrophic Coverage
$7
You pay 45% of the cost
You enter the Catastrophic Coverage Stage when you
have spent $4,700 out of pocket (not including monthly
premiums).
Generic Drugs You pay the greater of
5% coinsurance or $2.65 copay
All Other Drugs You pay the greater of
5% coinsurance or $6.60 copay
8
All Tiers may include generic and brand drugs
†
Plus Plan Costs by State
Your premium may be lower if you qualify for Extra Help.
See page 11 for more information.
Your State
Monthly Premium
Your State
Monthly Premium
AK
N/A
MT
$79.60
AL
$76.40
NC
$78.90
AR
$70.80
ND
$79.60
AZ
$81.10
NE
$79.60
CA
$89.30
NH
$84.80
CO
$89.20
NJ
$91.90
CT
$74.30
NM
$67.20
DC
$85.30
NV
$82.50
DE
$85.30
NY
$79.90
FL
$81.30
OH
$76.10
GA
$68.40
OK
$79.80
HI
$78.30
OR
$77.80
IA
$79.60
PA
$84.70
ID
$94.20
RI
$74.30
IL
$87.80
SC
$71.00
IN
$76.80
SD
$79.60
KS
$84.60
TN
$76.40
KY
$76.80
TX
$76.90
LA
$75.10
UT
$94.20
MA
$74.30
VA
$80.30
MD
$85.30
VT
$74.30
ME
$84.80
WA
$77.80
MI
$76.80
WI
$80.30
MN
$79.60
WV
$84.70
MO
$78.20
WY
$79.60
MS
$80.20
Questions about our plans or premiums?
Call SilverScript toll free at
1-866-552-6106, 24 hours
a day, 7 days a week. TTY users
call 1-866-552-6288.
For more plan and
premium information visit
www.silverscript.com
9
Something Extra for SilverScript Members
Your SilverScript membership qualifies you to receive
a complementary ExtraCare® Health Card. You may
use it as soon as it arrives in the mail, at any of more
than 7,6004 CVS/pharmacy stores nationwide8 or online
at www.cvs.com.
As a valued SilverScript member, your ExtraCare Health Card
entitles you to a healthy 20%7 discount on thousands of regularly
priced CVS/pharmacy Brand® health-related items valued at $1 or
more12 including:
•Allergy Remedies
•Incontinence
Products
•Baby Care
•Cough
•Nicotine
•Deodorant
•Oral
Care
•Diabetes
•Pain
Relievers
•Skin
Care
and Cold
Remedies
Testing
Supplies
Replacement
•Ear
Care
•Stomach
•Eye
Care
•Sunscreen
•Foot
Care
•Visual
•First
Aid Supplies
•Vitamins
Remedies
Aids
There is no cost to use
your ExtraCare Health Card
and no usage limit
The ExtraCare Health Card is not a plan
benefit, but a no-cost value-added service.
Questions about the ExtraCare Health Card program?
Call toll free, 1-888-543-5938, between 8:30 a.m.
and 7:00 p.m. EST. TTY users call 1-800-863-5488.
10
Need assistance to help pay for Medicare prescription drug coverage?
Extra Help is available from Medicare
People with limited resources and incomes can get Extra Help to pay all or some of their
Medicare Part D prescription drug costs. To qualify, you must meet three requirements:
1. Your Residence
You must reside in one of the 50 States or the District of Columbia.
2. Your Resources
Your resources must be limited to $13,440** for an individual or $26,860** for a
married couple living together. (Resources include bank accounts, stocks and
bonds, but do not include your home, car, or life insurance policies).
3. Your Income
Your income must be limited to $17,505** for an individual or $23,595** for
a married couple living together. Even if your income is higher, you may be
eligible for some help.
If you are eligible for Medicare, Medicaid and Extra Help, you
may qualify for a $0 monthly premium plan from SilverScript13.
Copays as low as $1.20 with Extra Help14.
Apply for Extra Help through the
Social Security Administration
If you believe you are eligible for Extra Help, complete the Application for Extra Help with
Medicare Prescription Drug Plan Costs and submit it to the Social Security Administration.
The Social Security Administration will notify you if you qualify. There are three ways to
contact Social Security:
By Phone
Call Social Security
toll free at 1-800-772-1213
(TTY 1-800-325-0778),
between 7:00 a.m. and
7:00 p.m. EST, Monday
through Friday
Online
Visit the Social
Security website at
www.socialsecurity.gov
In Person
Apply at your local
Social Security office
** 2014 limits may change in 2015.
11
Medicare Enrollment Periods
There are three Medicare enrollment periods for enrolling in or changing your Part D coverage.
Use this guide to determine the enrollment period that applies to your situation.
Your Situation
You’re eligible for
Initial
Enrollment Medicare because
you’ve turned 65
Period
(IEP)
What You Can Do
Enroll in
•A
Medicare Part D
Prescription Drug Plan
•Original
Medicare,15 or
•A
Medicare
Advantage Plan
You’re eligible for
Medicare because
you are disabled15
Enroll in
•A
Medicare Part D
Prescription Drug Plan
•Original
Medicare, or
When You Can Do It
Begins 3 months before
the month you turn 65
and includes the month
you turn 65
Ends 3 months after
the month you turn 65
Begins 21 months
after you get Social
Security (SS) or Railroad
Retirement Board (RRB)
benefits
•A
Ends on the 27th month
after you get SS or RRB
benefits
Begins October 15
Medicare
Advantage Plan
Annual
Election
Period
(AEP)
You want to enroll in
or change a Medicare
prescription drug plan
Enroll in, drop or
change
Special
Election
Period
(SEP)
You need to change
coverage due to a
special circumstance
If qualifying circumstances occur, Special Election
Periods can be anytime during the year. An SEP
allows you to make changes to your Medicare
Part D coverage or Medicare Advantage plan due
to special circumstances. Visit www.medicare.gov
for more information.
•A
Medicare Part D
Prescription Drug Plan
Ends December 7
Be aware of Medicare’s Late Enrollment Penalty
If you do not enroll in Medicare prescription drug coverage or do not have other
creditable coverage when your Initial Enrollment Period ends, Medicare will add a
Late Enrollment Penalty (LEP) to your premium when you do enroll. Creditable means
prescription drug coverage as good as Medicare, such as employer or union coverage.
Note: The LEP may not apply to you if you receive both Medicare and Medicaid. Visit
www.medicare.gov for more information.
12
Medicare’s Four “Parts”
Part A
Original Medicare
Hospital Coverage
•Inpatient
hospital care
•Inpatient stays at most skilled facilities
•Home health and Hospice care
Part B
Medical Coverage
•Doctor
and clinical lab services
•Outpatient and preventive care
•Screenings, surgical fees and supplies
•Physical and Occupational therapy
•Limited outpatient prescription drugs
Part C
Medicare Advantage
Part A and Part B into one
plan that can include Part D
•MA plan = Medicare Advantage Plan
•MA-PD = Medicare Advantage plan with
a prescription drug benefit
Part A +
Part B
Original Medicare is coverage managed
by the Federal government.
Prescription Drug Coverage (PDP)
Part D
There are two ways to get prescription
drug coverage:
•If you choose Original Medicare, you
can enroll in a stand-alone Medicare
prescription drug plan (a PDP), OR
•Through a Medicare Advantage Plan
that includes prescription drug coverage
(an MA-PD).
•Combines
Part D
Prescription Drug Coverage
•PDP
= Prescription Drug Plan
•MA-PD plan = Medicare Advantage plan
with a prescription drug benefit
Hospital +Medical + Prescription Drug Coverage
Part A +
Part B +
Part D
Remember, if you choose Original
Medicare, you must enroll in a standalone Part D plan (i.e. a PDP) to have
prescription drug coverage.
Adding Part D to Original Medicare
Part D coverage is not included with Original Medicare. If you do not have prescription drug
coverage from an employer, union or third party when you join Medicare, consider enrolling
in a stand-alone SilverScript plan to help cover the cost of your prescriptions.
13
Glossary of Terms
Deductible
An amount you are required to pay
before a plan begins to share the cost
of covered prescriptions.
Coinsurance
An amount you may be required to pay
as your share of the cost for prescription
drugs after you pay any deductibles.
Coinsurance is a percentage of the cost
(for example 20%).
Copay (Copayment)
An amount you may be required to
pay as your share of the cost for a
prescription drug. A copay is usually
a set dollar amount, for example a
$10 copay.
Cost Sharing
Any combination of deductible, copay
and/or coinsurance (not including
monthly premiums) that you may be
required to pay for covered prescription
drugs.
Mail Service Pharmacy
A pharmacy that fills and delivers
prescriptions ordered by phone, mail or
secure website5 that makes prescriptions
available only through mail order.
Network Pharmacy
A contracted pharmacy where plan
members can use their prescription
drug benefits. In most cases, your
prescriptions are covered by your
plan only if they are filled at a network
pharmacy.
Preferred Pharmacy
A pharmacy where SilverScript Plus
members get the lowest copays and
coinsurance on covered drugs.
Premium
The periodic payment to Medicare, an
insurance company or health care plan
for health or prescription drug coverage.
Coverage Gap (Donut Hole)
The third stage of Medicare Part D
prescription drug coverage following
the Initial Coverage stage.
Questions about SilverScript?
Call us toll free at 1-866-552-6106,
24 hours a day, 7 days a week.
TTY users call 1-866-552-6288.
14
Learn more online at
www.silverscript.com
Customer Care and Online Support
We call it Customer Care because all of us at SilverScript care about providing
friendly, efficient service and resolving any issue you may have as soon as possible.
Visit us online at www.silverscript.com to access the information you need, search
for drugs, review pricing, and find pharmacy locations. You can even communicate
online with a Customer Care Representative by using the Chat Now or Call Me
buttons located on the SilverScript website.
By phone or online, SilverScript is here for you 24 hours a day, 7 days a week. It’s
good to know that when you start on your path to better health with SilverScript,
we will be with you every step of the way.
You can reach SilverScript Customer Care by calling toll free, 1-866-552-6106,
24 hours a day, 7 days a week. TTY users call 1-866-552-6288.
Benefits Reminders
• The benefit information provided is a brief
summary, not a complete description of benefits.
For more information, contact the plan.
• Limitations, copayments and restrictions may
apply.
• Benefits, formulary, pharmacy network, premium
and/or co-payments/co-insurance may change
on January 1 of each year.
• You must continue to pay your Medicare Part B
premium.
• This information is available for free in other
languages. Please call our Customer Care
number at 1-866-552-6106 (TTY: 1-866-5526288), 24 hours a day, 7 days a week. Esta
información está disponible gratuitamente en
otros idiomas. Llame a nuestro Servicio al
Miembro, al 1-866-552-6106 (teléfono de texto
(TTY): 1-866-552-6288), las 24 horas del día, los
7 días de la semana.
1
CMS, Monthly Enrollment by Plan report, July,
2014. https://www.cms.gov/Research-StatisticsData-and-Systems/Statistics-Trends-andReports/MCRAdvPartDEnrolData/MonthlyEnrollment-by-Plan.html
2
CMS, Monthly Enrollment by Contract report,
July, 2014. https://www.cms.gov/ResearchStatistics-Data-and-Systems/Statistics-Trendsand-Reports/MCRAdvPartDEnrolData/MonthlyEnrollment-by-Contract.html
3
Choice plan in Alaska has a premium of $45.90
and deductible of $320.
4
Internal SilverScript Insurance Company report
dated July 2014.
5
Typical number of business days after the
pharmacy receives an order to receive your
shipment is 5 to 7 days.
SilverScript Insurance Company Formulary,
July 2014.
7
Some restrictions apply. ExtraCare Card must
be presented to get these savings. Savings
applied to total purchase with specified product.
Excludes prescriptions, alcohol, tobacco, lottery,
postage stamps, gift cards, money orders, prepaid cards and photo finishing, and is not valid
on items reimbursed by a government program.
No cash back. Tax charged on pre-coupon
price where required. Any disputes regarding
the products and services described may be
subject to the SilverScript grievance process.
8
You are not obligated to fill your prescriptions
at a CVS/pharmacy in order to use the CVS
Caremark ExtraCare Health Card.
9
Alaska Choice Plan has a $320 deductible
and Stage 2 copays/coinsurance of
$2/17%/37%/25% (Tiers 1-4).
10
Tier 4 Coinsurance is 33% for all plans except
Alaska.
11
SilverScript Plus (PDP) not available in Alaska.
12
Purchases using the ExtraCare Health Card
will not count towards your true-out-of-pocket
(TrOOP) costs under SilverScript. Any disputes
regarding the products and services described
may be subject to the SilverScript grievance
process.
13
You must qualify for Medicare, Medicaid and
Extra Help from Medicare to be eligible for $0
premiums on your prescription drug coverage.
Note: $0 premium plans are not available in
Alaska and Nevada.
14
CMS 2014 Your Guide to Medicare Prescription
Drug Coverage June 2014.
15
Original Medicare refers to Medicare Part A and
Part B.
6
15
Enroll Your Way
SilverScript believes in giving you choices. Choose from two different plans
and then select your enrollment method. Be sure to have the items listed in
Your Enrollment Checklist on hand before you begin your enrollment.
Enroll Online
It’s easy and convenient to complete and submit
your enrollment application securely online at
www.silverscript.com.
Your Enrollment Checklist
Or
Enroll by Phone
Complete your enrollment application over the
phone with the help of a SilverScript Customer Care
Representative. Call us toll free at 1-866-552-6106,
24 hours a day, 7 days a week. TTY users call
1-866-552-6288.
Or
Complete a Paper Application
Use the enclosed SilverScript application. Follow
the instructions, sign and mail using the enclosed
postage paid envelope.
www.medicare.gov
You may also enroll in a Medicare Part D
prescription drug plan – including any
SilverScript 2015 stand-alone Medicare
Part D prescription drug plan in this Guide –
by visiting www.medicare.gov.
Your red, white and blue
Medicare card (or the letter
you received from either the
Social Security Administration
or Railroad Retirement Board)
Your Medicaid number (if you
have Medicaid)
An up-to-date list of all
prescription drugs you take
Information about other
health coverage you or your
spouse have including:
•
Group health plan
information
•
Employment information
•
Dates of coverage
Once you enroll in a plan, you will receive a
Member ID card and a Welcome Kit from SilverScript.
SilverScript is a Prescription Drug Plan with a Medicare contract offered by SilverScript
Insurance Company. Enrollment in SilverScript depends on contract renewal.
©2014 SilverScript Insurance Company. All Rights Reserved.