Express Scripts Medicare - Saver (PDP)

Prescription Drug Plan for Indiana

select spinner

Plan Summary

Insurance TypeMedicare Advantage Prescription Drug Plan (Part D)
Insurance ProviderExpressScripts
Plan IDS5660-231-0
CMS Rating1
Plan TypePDP
Annual Deductible$405.00

What To Know About This Plan

  • This is a drug coverage only plan

Why We Like This Plan

  • has a copay of $1 for Tier 1 preferred generic drugs (30 day supply, preferred retail pharmacies)

Plan Details

Costs and Other Important Information

Plan Year:
Optional Supplemental Benefits
Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)
Not Applicable
Other health plan deductibles?
Health Plan Deductible
Coming soon
Monthly Drug Plan Premium
Monthly Health Plan Premium
Not Applicable


Inpatient hospital coverage
Coming soon
Outpatient hospital coverage
20% per visit
Doctor visits
Primary:20% per visit
Specialist:20% per visit
Preventive care
Emergency care/Urgent care
Urgent care:20%
Diagnostic procedures/lab services/imaging
Diagnostic tests and procedures:20%
Lab services:20%
Diagnostic radiology services (e.g., MRI):20%
Outpatient x-rays:20%
Mental health services
Coming soon
Outpatient group therapy visit with a psychiatrist:20%
Outpatient individual therapy visit with a psychiatrist:20%
Outpatient group therapy visit:20%
Outpatient individual therapy visit:20%
Skilled Nursing Facility
Coming soon
Rehabilitation services
Occupational therapy visit:20%
Physical therapy and speech and language therapy visit:20%
Foot care (podiatry services)
Foot exams and treatment:20%
Routine foot care:20%
Medical equipment/supplies
Durable medical equipment (e.g., wheelchairs, oxygen):20% per item
Prosthetics (e.g., braces, artificial limbs):20% per item
Diabetes supplies:20% per item
Wellness programs (e.g., fitness, nursing hotline)
Medicare Part B drugs
Other Part B drugs:20%

Coverage Area for Express Scripts Medicare - Saver (PDP)


Cost Sharing Information

All cost-sharing assumes in-network healthcare providers.

Prescription Drug Copay/Coninsurance Details - Initial Coverage Limit

30 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred Generic$1 copay$5 copayNot offered
Tier 2: Non-Preferred Generic$4 copay$10 copayNot offered
Tier 3: Preferred Brand Name18% coinsurance20% coinsuranceNot offered
Tier 4: Non-Preferred Brand Name46% coinsurance48% coinsurance48% coinsurance
Tier 5: Specialty Tier25% coinsurance25% coinsurance25% coinsurance
90 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred Generic$3 copay$15 copay$2 copay
Tier 2: Non-Preferred Generic$12 copay$30 copay$8 copay
Tier 3: Preferred Brand Name18% coinsurance20% coinsurance18% coinsurance
Tier 4: Non-Preferred Brand Name
Tier 5: Specialty Tier

CMS Ratings

Drug Plan Customer Service

Call center – foreign language interpreter and TTY/TDD availability - Drugs
Not Rated
Appeals auto-forward
Not Rated
Appeals upheld

Member Complaints, and Changes in Drug Plan's Performance

Complaints about the drug plan
Members choosing to leave the drug plan
Beneficiary access and performance problems
Drug plan quality improvement

Member Experience with Drug Plan

Rating of drug plan
Getting needed prescription drugs

Drug Pricing and Patient Safety

MPF Price Accuracy
High risk medication
Part D medication adherence for diabetes
Part D medication adherence for hypertension
Part D medication adherence for cholesterol
Medication Therapy Management program completion rate

Pharmacy Finder

Pharmacies that accept Express Scripts Medicare - Saver (PDP) Prescription Drug Plan for Indiana


No results found. Try changing the search distance or zip code.

Similar Plans

PremiumPlan NameCMS Rating
from $23
SilverScript Choice (PDP)
from $0
Aetna Medicare Value Plan (PPO)
from $0
HumanaChoice H5216-018 (PPO)
from $0
AARP MedicareComplete Plan 1 (HMO)
from $0
Anthem MediBlue Plus (HMO)

Related Articles

Related Searches

HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, Medicaid or an individual health insurance plan, we will help you find the right healthcare option and save on your out of pocket healthcare costs. We receive our data from government, non-profit and private sources, and you should confirm key provisions of your coverage with your selected health plan. If you select a plan presented on our site, you will be directed (via a click or a call) to one of our partners who can help you with your application. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan.