Clear Spring Health offers two Medicare Part D (or prescription drug)
plans: Value and Premier. Both include an extensive list of covered generic and brand-name prescription drugs and thousands of local
and national pharmacies.

Español

Para asistencia en español, llame al:

(877) 317-6082; TTY: 711 y oprima el número 2

Nuestro horario es

de 8:00 a.m. a 8:00 p.m., hora local, los 7 días de la semana.
Si llama del 1ro de abril al 30 de septiembre, se usará sistema
automatizado de voz (correo de voz) durante los fines de semana
y los días feriados.

Our Contacts

To learn more, please call

(877) 317-6082; TTY: 711

Clear Spring Health,

PO Box 278530
Miramar, FL 33027

Hours of Operation

8:00 a.m. – 8:00 p.m., 7 days a week
(Between April 1 – September 30, voicemail will be available on Saturday, Sunday and federal holidays.)

Clear Spring Health Deluxe (HMO D-SNP) -

Home > Clear Spring Health Deluxe (HMO D-SNP) -

Discover Clear Spring Health Deluxe (HMO D-SNP) -

Overview

Additional Information

Keep your costs low with a Health Maintenance Organization (HMO) plan that has a SO or low monthly premium.

Monthly Premium
Provider
Find a Participating Provider
Covered Prescription Drug
Find a Covered Drug
Pharmacy
Find a Participating Pharmacy

Medical Coverage

Medical Deductible

Maximum Out-of-Pocket

Primary Care Physician (PCP)
Office Visit

Specialist Office Visit

Inpatient Hospital Care

Skilled Nursing Facility (SNF)

Outpatient Services/Surgery

Ambulatory Surgery Center

Outpatient Mental Health Care

Telehealth Services

Emergency Room

Urgently Needed Care

Ambulance Services

Diagnostic Tests, Lab and Radiology Services, and X-Rays

Home Health Care

Chiropractic Services

Podiatry Services

Dental Care

Hearing Services

Vision Services

Fitness Benefit

Over-the-Counter Items

Transportation

Durable Medical Equipment (DME)

Pharmacy Deductible

Initial Coverage Limit

Covered Prescription Drug Benefits
Pharmacy Option
Edit
.
Tier 1: Preferred Generic
Tier 2: Generic
Tier 3: Preferred Brand
Tier 4: Non-Preferred Drug
Tier 5: Specialty
Retail – Standard Pharmacy
Edit
30-day supply
Mail-Order
Edit
30-day supply
Disenrollment Form
Enrollment Form
Evidence of Coverage
Formulary
LIS Premium Chart
Multi language Interpreter Services
Notice of Non-Discrimination
Over-the-Counter Catalog
Pharmacy Directory
Pre-Enrollment Checklist
Provider Directory
Star Rating
Summary of Benefits

Clear Spring Health
Deluxe (HMO D-SNP) -

Monthly Premium

Contract Number:

Enroll Now
  • Enrollee must continue to pay their Medicare Part B premium. This information is not a complete description of benefits. Call 1-877-364-4566 (TTY: 711) for more information.

  • Clear Spring Health’s pharmacy network includes limited lower-cost, preferred pharmacies. The lower costs advertised in our plan materials for these pharmacies may not be available at the pharmacy you use. For up-to-date information about our network pharmacies, including whether there are any lower-cost preferred pharmacies in your area, please call or consult the online Pharmacy Locator.

  • Other pharmacies and other providers are available in our network.

  • Out-of-network/non-contracted providers are under no obligation to treat Clear Spring Health plan members, except in emergency situations. Please call Member Service or review the Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.

Provider

Additional Information

Keep your c

Additional Information

Keep your c

Additional Information

Keep your c

Enrollment is Easy!

Preferred Pharmacy Cost-Sharing

Pharmacy Option

Edit
.
Tier 1: Preferred Generic
Tier 2: Generic
Tier 3: Preferred Brand
Tier 4: Non-Preferred Drug
Tier 5: Specialty

Retail – Standard Pharmacy

Edit
30-day supply
$1
$3
$40
40%
25%

Edit
90-Day Supply
$3
$9
$120
40%
25%

Mail-Order

Edit
30-day supply
$1
$3
$40
40%
25%

Edit
90-Day Supply
$3
$9
$120
40%
25%