Our Value Plan is our lowest cost Medicare Part D Plan. This plan is designed for beneficiaries who have minimal to moderate prescriptions with low premiums and cost-sharing but a large selection of 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 Value 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 Value SearchThe following documents provide information on the Value 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)
Region | Description | Total Premium (Basic+Supp) |
Download LIS Value Summary Sheet |
---|---|---|---|
04 | NJ | $29.30 | Download |
05 | DC, DE, MD | $28.10 | Download |
06 | PA, WV | $29.20 | Download |
07 | VA | $26.30 | Download |
08 | NC | $24.70 | Download |
09 | SC | $22.50 | Download |
10 | GA | $23.80 | Download |
11 | FL | $26.90 | Download |
12 | AL, TN | $27.10 | Download |
13 | MI | $27.50 | Download |
14 | OH | $24.10 | Download |
15 | IN, KY | $27.00 | Download |
16 | WI | $29.30 | Download |
17 | IL | $24.50 | Download |
18 | MO | $27.50 | Download |
19 | AR | $24.00 | Download |
20 | MS | $24.10 | Download |
21 | LA | $29.30 | Download |
22 | TX | $19.80 | Download |
23 | OK | $27.00 | Download |
24 | KS | $29.20 | Download |
25 | IA, MN, MT, ND, NE, SD, WY | $29.30 | Download |
28 | AZ | $30.70 | Download |
29 | NV | $22.80 | Download |
30 | OR, WA | $31.10 | Download |
31 | ID, UT | $30.90 | Download |
32 | CA | $29.50 | Download |
33 | HI | $26.70 | Download |
34 | AK | $28.80 | Download |
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Annual Notice of Change
Appointment of Representative
Evidence of Coverage