Glossary and Resources

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%). 

An amount you may be required to pay as your share of the cost for a prescription drug after you pay for any deductible. A copay is usually a set dollar amount (for example: a $10 copay).

A Medicare prescription drug coverage stage following the Initial Coverage stage. The Coverage Gap begins after the total annual drug costs paid by you and your plan have reached $3,750 (in 2018) and $3,820 (in 2019) not counting your premium payments. You leave the Coverage Gap when your True Out-Of-Pocket (TrOOP) costs reach $5,000 (in 2018) and $5,100 (in 2019), not counting premiums. Note: these dollar limits are subject to change each year.

An amount you are required to pay before a plan begins to share the cost of prescriptions.

A prescription drug that is approved by the Food and Drug Administration (FDA) as having the same active ingredient(s) as the brand name drug. Generally, a “generic” drug works the same as a brand name drug and usually costs less.

A pharmacy that doesn’t have a contract with our plan to coordinate or provide covered drugs to members of our plan. As explained in the Evidence of Coverage, most drugs you get from out-of-network pharmacies are not covered by our plan unless certain conditions apply.

See the definition for “cost-sharing”.  A member’s cost-sharing requirement to pay for a portion of drugs received is also referred to as the member’s “out-of-pocket” cost requirement.

The periodic payment to Medicare, an insurance company, or a health care plan for health or prescription drug coverage.

For additional assistance, please visit our glossary section.

The factors above are different for each plan. But before you compare the costs of our plans, consider your location. Plan costs and benefits vary by area, so make sure you type in your zip code to see the correct plan costs benefits.

Some members may face additional costs or fees. For example, the Late Enrollment Penalty (LEP) is an amount added to your Medicare Part D premium. You will owe a late enrollment penalty if, at any time after your Initial Enrollment Period is over, there's a period of 63 or more days in a row when you don't have Part D or other creditable prescription drug coverage (as good as Medicare’s).

Financial assistance is also available for eligible members. See if you qualify for Extra Help, a Social Security Administration program that helps people with limited incomes pay for their Medicare Part D costs.

Plan Decision

Plan Decision Guide

Make an Informed Medicare Part D Choice

This SilverScript Plan Decision Guide makes it easy to compare plans and uncover what the true cost of your plan could be — to help you make an informed choice that works for your health and your budget.

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Plan Comparison

Plan Costs Worksheet

Easily Compare Plans, No Printer Required!

Stuck between two plans? Simply download the Plan Costs Worksheet, select your refill preferences, and type your costs into the blank spaces that are highlighted. It’s easier to find the plan that’s right for you when you can see your options side by side.

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