• Clear Spring Health Premier Rx (PDP)

    Discover the Clear Spring Health Premier Rx (PDP)

    Our Premier Plan is our most comprehensive Medicare Part D plan. This plan is designed for beneficiaries with moderate to high prescription drug needs including access to a broad list of covered generic and brand-name prescription drugs and thousands of participating pharmacies.

    Enroll Now

    Find a Pharmacy

    Our Medicare Part D plans have over 60,000 participating pharmacies including local and national chains. Enter your state, city or zip code into our “Locate a Pharmacy” tool to find the participating pharmacies closest to you.

    Perform Search

    Formulary Search Tool

    The Clear Spring Health Premier Rx Formulary (or covered drug listing) includes thousands of generic and brand-name prescription medications. Use this tool to find your prescription drug(s), dosage and cost-sharing.

    Perform Premier Search

    2021 Plan Documents

    The following documents provide information on the Premier Plan benefits, covered prescription drugs and participating pharmacies. Select your state from the drop-down menu to view each document.

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    Benefit Summary (English)

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    Benefit Summary (Spanish)

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    Covered Drug List

    Download

    Pharmacy Directory

    Download

    Plan Ratings (English)

    Download

    Plan Ratings (Spanish)

    Download

    Privacy Notice under the
    HIPAA Privacy Rule

    Download

    2020 Plan Documentation

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    Summary of Benefits

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    Summary of Benefits (Spanish)

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    Evidence of Coverage

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    2020 Directories

    Pharmacy Directory

    Download

    Premier Rx Formulary

    Download

    Plan Premiums By State 2021

    Region Description Total Premium
    (Basic+Supp)
    Download LIS Premier
    Summary Sheet
    04 NJ $13.50 Download
    05 DC, DE, MD $13.70 Download
    06 PA, WV $13.60 Download
    07 VA $15.40 Download
    08 NC $13.90 Download
    09 SC $14.10 Download
    10 GA $14.40 Download
    11 FL $13.50 Download
    12 AL, TN $13.50 Download
    13 MI $13.60 Download
    14 OH $15.20 Download
    15 IN, KY $15.40 Download
    16 WI $13.60 Download
    17 IL $15.40 Download
    18 MO $13.60 Download
    19 AR $16.70 Download
    20 MS $14.50 Download
    21 LA $13.70 Download
    22 TX $13.80 Download
    23 OK $13.70 Download
    24 KS $14.50 Download
    25 IA, MN, MT, ND, NE, SD, WY $14.30 Download
    28 AZ $15.50 Download
    29 NV $13.80 Download
    30 OR, WA $14.00 Download
    31 ID, UT $15.00 Download
    32 CA $13.30 Download
    33 HI $14.90 Download
    34 AK $14.70 Download

    Member Plan Documents

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    Annual Notice of Change

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    Appeals and Grievance Process

    Download

    Appointment of Representative

    Download

    Electronic Funds Transfer (ETF) Authorization Form

    Download

    Evidence of Coverage

    *

    Member Rights and Responsibilities

    Download

    Medication Therapy Management Program

    Download

    Interested? Enroll Today!

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    Last Updated on November 17, 2020, 11:25 pm CST

    Y1045_MK_W003-092520

    Clear Spring Health, PO Box 278530 Miramar, FL 33027

    ©Copyright Clear Spring Health | All Rights Reserved


    Clear Spring Health has a contract with Medicare to offer PPO, HMO, and PDP Plans. Enrollment in these plans depends on contract renewal.

    To learn more, please call (877) 317-6082; TTY: 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. (Voicemail will be available on Saturday, Sunday and Federal holidays).

    Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al (877) 317-6082 (TTY: 711).