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.
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 SearchThe 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 SearchThe 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)
Benefit Summary (Spanish)
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Summary of Benefits
Summary of Benefits (Spanish)
Evidence of Coverage
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 |
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Annual Notice of Change
Appointment of Representative
Evidence of Coverage