Prescription Drug Plan
Effective Jan. 1, 2020, MSU will have a new prescription drug plan called SilverScript Employer Prescription Drug Plan for those eligible for Medicare. The plan is offered by SilverScript® Insurance Company which is affiliated with CVS Caremark®, MSU's current pharmacy benefit manager. SilverScript combines a standard Medicare Part D prescription drug plan with additional coverage provided by MSU to close the gaps between the standard Part D plan and your current coverage.
Why is SilverScript being implemented?
SilverScript is a program that allows MSU and Medicare eligible retirees to take advantage of better pricing and governmental assistance programs while providing a high-quality, low cost pharmacy benefit.
Is there an impact on me or my dependent(s)?
If you are not eligible for Medicare, you will continue to be covered by the CVS Caremark plan and continue to use your current ID card.
If you are eligible for Medicare, you will be automatically enrolled in SilverScript and receive a new prescription card. The new prescription card will allow you to provide one card to their pharmacist and coordinate coverage under SilverScript Medicare Part D.
How will my prescription coverage be impacted?
SilverScript coverage has been custom-tailored for participants in MSU's retiree medical plan.
- You will have prescription drug benefits that align to your current plan. Under your current plan, the list of approved drugs changes throughout the year based on availability of generics and new drugs that become available. SilverScript will use the same process.
- As with your current plan, there is no deductible with SilverScript.
- You will pay the same copays for generic, preferred brand and non-preferred brand drugs. The current copays for a 34-day supply are $10 for generic drugs; $30 for preferred brand-name drugs; $60 for non-preferred brand-name drugs and $75 for specialty drugs.
- You will have access to the retail pharmacies and the CVS mail-order pharmacy that are in your current CVS Caremark pharmacy network.
- New under the SilverScript plan: A 90-day supply of maintenance drugs can be filled at a SilverScript preferred network retail pharmacy at the same cost as mail order.
- New under the SilverScript plan: You will have access to SilverScript network long-term care and home infusion pharmacies not in the current pharmacy network.
How will I enroll and/or get insurance cards?
You do not need to enroll in the Medicare Part D plan. MSU will automatically enroll you in SilverScript and SilverScript will submit your enrollment information to Medicare. If additional information is needed to process enrollment, such as your Medicare Number or physical street address, SilverScript will contact you directly.
All covered individuals automatically enrolled for Medicare will receive their own explanation of benefits and ID cards in the mail from SilverScript.
What is the cost to me?
University contribution toward prescription coverage is dependent on your hire date and/or FTE service level. Review the Retiree Benefits Policy & Procedure for more details.
There may be an extra fee for you to be enrolled in the group Medicare Part D plan based on your adjusted gross income (AGI). Medicare annually reviews and sets AGI thresholds. This is known as Part D Income Related Monthly Adjustment Amount, also known as Part D-IRMAA. If a monthly fee applies, the fee will be deducted from your Social Security Income like Medicare Part B.
*Rates are determined on a sliding scale based on income level. More information can be found on the Medicare website.
Low-income retirees will not pay a monthly fee for Part D and will have greater access to government assistance programs to help with prescription drug costs. For 2018, low income was defined as an AGI of $18,210 for an individual or $24,690 for a married couple.
Is there a different formulary for the SilverScript plan?
The SilverScript Plan will have a Medicare approved formulary and an enhanced plan that has the same formulary as the regular CVS Caremark plan used by retirees under the age of 65.
Will my approval for specialty drugs and/or prior authorization be accepted under SilverScript?
Approvals or prior authorizations in place for you or a spouse age 65 or older on 01/01/2020, will need to be renewed. Communication will be sent directly to those impacted starting in Oct. 2019. You will have a transition fill that will allow you to receive up to three months of prescriptions while you are working through the renewal process. In addition, if you or a spouse turn age 65 after 01/01/2020 and ongoing, you will also be given a transition fill to receive up to three months of prescriptions while working through the renewal process.
Can I opt out of SilverScript?
When you enroll in health insurance through MSU, you are automatically enrolled in prescription coverage. You can opt out of health and prescription benefits through MSU, however you cannot have health benefits without prescription coverage.
MSU HR will be hosting informational meetings where you can come to find out more about this change and get your questioned answered. Space is limited; please RSVP for one of the following meetings. Content covered at all sessions will be the same.
Kellogg Center, Auditorium
If sessions fill up, we will make additional sessions available. A video recording of the informational meeting will be made available in September.
More detailed information will be issued in advance of Jan. 1, 2020. Starting in Oct. 2019 you will be able to contact SilverScript Customer Care with any questions or to learn more about how the plan will work.