Drug Pricing for 2021 PDP plans on this website will be available on October 20, 2020. Please check our website on or after this date.

Updated drug pricing for 2021 Express Scripts Medicare PDP plans will be available on Medicare.gov as of October 26, 2020. If you consulted drug pricing on Medicare.gov prior to October 26, 2020 you may wish to check the updated information.

2021

PLAN
INFORMATION

Saver Plan

Our lowest premiums, $0 deductible for many generic drugs, and $0 or low copays at preferred home delivery or retail pharmacies.

Plan Costs

Premium

A premium is a monthly payment for prescription drug coverage.

Annual Deductible

A deductible is the amount that you pay out-of-pocket for prescriptions before the plan begins to pay.

Initial Coverage Stage

The Initial Coverage Stage begins after you have met your annual deductible (if your plan has one) and ends when your total drug costs reach the initial coverage limit. In this stage, you will pay the amounts listed based on the drug tier and the pharmacy you use.

What are drug tiers?

What are drug tiers?
Each drug on a formulary (drug list) is placed on a tier, based on its cost.

Preferred Home Delivery
90-day supply
Tier 1:
Preferred Generic
$0
Tier 2:
Generic
$8
Tier 3:
Preferred Brand
$90
Tier 4:
Non-preferred drugs
From38% to - 50%
For(30 days)supply
Tier 5:
Specialty drugs
25%
For(30 days)supply
Preferred Retail
30-day supply
Tier 1:
Preferred Generic
$1
Tier 2:
Generic
$4
Tier 3:
Preferred Brand
$30
Tier 4:
Non-preferred drugs
From36% to - 48%
For(30 days)supply
Tier 5:
Specialty drugs
25%
For(30 days)supply
Standard Retail
30-day supply
Tier 1:
Preferred Generic
$9
Tier 2:
Generic
$12
Tier 3:
Preferred Brand
$39
Tier 4:
Non-preferred drugs
From38% to - 50%
For(30 days)supply
Tier 5:
Specialty drugs
25%
For(30 days)supply

Coverage Gap Stage

You will enter the Coverage Gap Stage when your total drug costs exceed $4,130. In this stage, you will pay the amounts listed.

Catastrophic Coverage Stage

You will enter the Catastrophic Coverage Stage when your yearly out-of-pocket costs exceed $6,550. In this stage, you will pay the amounts listed.

Monthly premiums and copays/coinsurance may vary by region. For details, please see the Summary of Benefits or call an Express Scripts Medicare advisor. Remember, you must continue to pay your Medicare Part B premium.

*You pay $35 for Tier 3 select insulins at all network pharmacies in all stages up to the Catastrophic Coverage Stage.

Drug Coverage

The Saver plan Medicare Part D Formulary (drug list) has more than 2,900 drugs, including the most commonly used medications.

The Part D Senior Savings Model offers Tier 3 select insulin drugs at an affordable and predictable price to Saver plan members at any network pharmacy, in all stages up to the Catastrophic Coverage Stage. View a list of the included drugs.

If you receive "Extra Help," you do not qualify for this program, and your Low-Income Subsidy copay level will apply.

Pharmacy Network

Preferred retail pharmacies

In addition to a broad network of standard retail pharmacies, our Saver plan offers low copays at these preferred retail pharmacies:

CVS Pharmacy
Walmart
Kroger

The Kroger Family of Pharmacies includes Baker's, City Market, Dillons, Fred Meyer, Fry's, Gerbes, Harris Teeter, JayC, King Soopers, Mariano's, Metro Market, Owens, Payless, Pick 'n Save, QFC, Ralphs and Smith's.

Preferred home delivery from Express Scripts Pharmacy®

If you take prescription drugs on a regular basis, consider the added safety, convenient service and potential savings of having a 90-day supply delivered right to your mailbox.

  • Low costs. Get up to a 90-day supply of your medication for a low copay or coinsurance.
  • Added safety and convenience. We mail directly to your home so you can avoid making trips and waiting in line at the pharmacy. Medications typically arrive within 10 days after we receive the prescription from your doctor.
  • Free standard shipping. Shipping is included as part of your plan at no additional cost.
  • 24/7 care and service. Express Scripts pharmacists are available by phone to answer your medication questions, even in the middle of the night.
  • Easy refills. Order refills quickly and easily on our website, with the Express Scripts® mobile app, by phone or by mail.

Do I have to use a “preferred retail” pharmacy?

Do I have to use a “preferred retail” pharmacy?
You may use any pharmacy in your plan’s network, but you typically pay less when you use a preferred retail pharmacy or preferred home delivery from Express Scripts Pharmacy®.

Please note: You may use our online searchable tool to confirm if your drugs are covered and which pharmacies are in-network. You may also compare all plans offered by Express Scripts Medicare if you are unsure which is best for you.

Need help?

Call 1.866.477.5703 TTY users: 1.800.716.3231
8 a.m. to 8 p.m., 7 days a week, except Thanksgiving and Christmas

Other pharmacies are available in our network.

If you qualify for Extra Help from Medicare to pay for your prescription drug costs, the amounts listed here may not apply to you.

Medicare Part B prescription drugs are not covered under the prescription drug benefit (Part D). Generally, we cover only prescription drugs, vaccines, biological products and medical supplies that are covered under the Medicare prescription drug benefit (Part D) and that are on our formulary.

Express Scripts Medicare's pharmacy network includes limited lower-cost, preferred pharmacies in rural areas in Alaska; the Saver plan also includes limited lower-cost, preferred pharmacies in suburban areas in Puerto Rico, and the Choice plan also includes limited lower-cost, preferred pharmacies in rural areas in Oklahoma. The lower costs advertised in our plan materials for these pharmacies may not be available at the pharmacy you use. For up-to-date information about our network pharmacies, including whether there are any lower-cost preferred pharmacies in your area, please call Customer Service at 1.866.477.5703; TTY: 1.800.716.3231, or consult the online pharmacy directory.

Certain prescription drugs will have maximum quantity limits.

Your prescriber must get prior authorization from Express Scripts Medicare for certain prescription drugs.

Covered Part D drugs are available at out-of-network pharmacies under certain circumstances, including illness while traveling outside the plan's service area, where there is no network pharmacy. You may also incur an additional cost for drugs received at an out-of-network pharmacy.

We have free interpreter services available to answer any questions you may have about the plan.
View information on multi-language interpreter services.