• PDP Value Plan

    Discover the Clear Spring Health PDP Value Plan

    Our PDP Value Plan is bursting with exceptional value in prescription drug coverage and in-network pharmacy options designed to help you save money on your prescriptions.

    Navigate Our Plan Information with the hubs below.

    Enroll Now

    Service Area


    Find Your Pharmacy

    Our plans provide you the opportunity to save on copays by using a national preferred retail network pharmacy. To view a list of network pharmacies in your area, please select the search below.

    Perform Search

    Look Up Your Drugs

    The Drug Coverage tool reveals which drugs are covered by our plan and provides information on copay Tier.

    Perform Value Search

    2021 Plan Documentation

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    Summary of Benefits

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    Summary of Benefits (Spanish)

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    Evidence of Coverage

    *

    Annual Notices of Change

    *

    2021 Directories

    Pharmacy Directory

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    Value Rx Formulary

    Download

    2020 Plan Documentation

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    Summary of Benefits

    *

    Summary of Benefits (Spanish)

    *

    Evidence of Coverage

    *

    2020 Directories

    Pharmacy Directory

    Download

    Value Rx Formulary

    Download

    Plan Premiums By State 2021

    Region Description Total Premium
    (Basic+Supp)
    Download LIS Value
    Summary Sheet
    04 NJ $29.30 Download - (Coming Soon)
    05 DC, DE, MD $28.10 Download - (Coming Soon)
    06 PA, WV $29.20 Download - (Coming Soon)
    07 VA $26.30 Download - (Coming Soon)
    08 NC $24.70 Download - (Coming Soon)
    09 SC $22.50 Download - (Coming Soon)
    10 GA $23.80 Download - (Coming Soon)
    11 FL $26.90 Download - (Coming Soon)
    12 AL, TN $27.10 Download - (Coming Soon)
    13 MI $27.50 Download - (Coming Soon)
    14 OH $24.10 Download - (Coming Soon)
    15 IN, KY $27.00 Download - (Coming Soon)
    16 WI $29.30 Download - (Coming Soon)
    17 IL $24.50 Download - (Coming Soon)
    18 MO $27.50 Download - (Coming Soon)
    19 AR $24.00 Download - (Coming Soon)
    20 MS $24.10 Download - (Coming Soon)
    21 LA $29.30 Download - (Coming Soon)
    22 TX $19.80 Download - (Coming Soon)
    23 OK $27.00 Download - (Coming Soon)
    24 KS $29.20 Download - (Coming Soon)
    25 IA, MN, MT, ND, NE, SD, WY $29.30 Download - (Coming Soon)
    28 AZ $30.70 Download - (Coming Soon)
    29 NV $22.80 Download - (Coming Soon)
    30 OR, WA $31.10 Download - (Coming Soon)
    31 ID, UT $30.90 Download - (Coming Soon)
    32 CA $29.50 Download - (Coming Soon)
    33 HI $26.70 Download - (Coming Soon)
    34 AK $28.80 Download - (Coming Soon)

    Plan Premiums By State 2020

    Region Description Total Premium
    (Basic+Supp)
    Download LIS Value
    Summary Sheet
    04 NJ $31.70 Download
    05 DC, DE, MD $26.10 Download
    06 PA, WV $33.00 Download
    07 VA $27.50 Download
    08 NC $25.00 Download
    09 SC $21.60 Download
    10 GA $22.90 Download
    11 FL $26.50 Download
    12 AL, TN $27.80 Download
    13 MI $29.20 Download
    14 OH $30.00 Download
    15 IN, KY $29.00 Download
    16 WI $32.20 Download
    17 IL $24.40 Download
    18 MO $29.20 Download
    19 AR $23.70 Download
    20 MS $23.60 Download
    21 LA $29.70 Download
    22 TX $21.40 Download
    23 OK $27.50 Download
    24 KS $28.70 Download
    25 IA, MN, MT, ND, NE, SD, WY $32.40 Download
    28 AZ $29.50 Download
    29 NV $23.60 Download
    30 OR, WA $30.50 Download
    31 ID, UT $32.70 Download
    32 CA $29.70 Download
    33 HI $24.80 Download
    34 AK $30.20 Download

    Member Documentation

    Appointment of Representative

    Download

    Disenrollment Form

    Download

    Member Rights and Responsibilities

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    Appeals and Grievance Process

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    Utilization Management Program

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    Quality Improvement Program

    Download

    Electronic Funds Transfer (ETF) Authorization Form

    Download

    Interested? Enroll Today!

    Get Started

    Last Updated on September 18, 2020, 7:37 am CDT

    Y1045_MK_W003-092520

    Clear Spring Health, PO Box 278530 Miramar, FL 33027 ©Copyright 2020 Clear Spring Health. All rights reserved.


    Clear Spring Health has a contract with Medicare to offer PPO, HMO, and PDP Plans. Eon Health has a contract with the Georgia Medicaid program and a contract with the South Carolina Medicaid program. Enrollment in these plans depends on contract renewal.

    To learn more, please call (877) 364-4566 TTY users should call 711. Our office hours are October 1 – March 31, seven days a week, 8:00 a.m. – 8:00 p.m. and from April 1 – September 30, Monday through Friday, 8:00 a.m. – 8:00 p.m. (you may leave a voicemail Saturday, Sunday and Federal Holidays).

    Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística.Llame al 1-877-364-4566 (TTY: 711)