The SilverScript Employer PDP sponsored by The Group Insurance Commission 2019 Benefit Summary:

If you enroll in another Medicare prescription drug plan or a Medicare Advantage Plan with or without prescription drug coverage, you will be disenrolled from the GIC-sponsored plan. If you are disenrolled from SilverScript, you will lose your GIC medical, prescription drug and behavioral health coverage

Monthly Premium, Deductible, and Limits on How Much You Pay for Covered Services
Premium There is no separate prescription drug premium. This benefit is provided as part of your health plan coverage. If you have any questions about your premium, contact the GIC’s Public Information Unit at 617-727-2310, TTY users: Relay Service 711; available 8:45 a.m. to 5:00 p.m., Monday through Friday. You must continue to pay your Medicare Part B premium, if applicable.
Deductible This plan does not have a deductible.
Initial Coverage You pay the amounts below until your total yearly drug costs reach $3,820. Total yearly drug costs are the total drug costs for Part D drugs paid by both you and the plan.

You may get your drugs at network retail pharmacies and mail-order pharmacies1. Some of our network pharmacies are preferred network retail pharmacies. You will also pay the same as mail-order for a 90-day supply of a maintenance medication at preferred network retail pharmacies.

Certain drugs are limited to a 30-day supply. These drugs have “NDS” next to them in the formulary.
Tier Up to a 30-day supply
at any retail network pharmacy
Up to a 90-day supply
at a preferred retail
network pharmacy
Up to a 90-day supply
at a non-preferred retail network pharmacy
Tier 1 - Generics
$10
$25
$30
Tier 2 - Preferred Brands
$30
$75
$90
Tier 3 - Non-Preferred Brands
$65
$165
$195
Tier Up to a 90-day supply through the mail-order pharmacy
Tier 1 - Generics
$25
Tier 2 - Preferred Brands
$75
Tier 3 - Non-Preferred Brands
$165

Note: You pay the same share of the cost for your drug filled through the Mail-Order Pharmacy, whether you get a one-month supply or a long-term supply. This means that the copayment or coinsurance listed above is applicable for any order, regardless of the day supply (1-90 days).
Tier Up to a 31-day supply at a long-term care (LTC) facility
Tier 1 - Generics
$10
Tier 2 - Preferred Brands
$30
Tier 3 - Non-Preferred Brands
$65
Coverage Gap Due to the additional coverage provided by the GIC, you pay the same copay that you paid during the Initial Coverage Stage. You will see no change in your copay until you qualify for Catastrophic Coverage.
Catastrophic Coverage

After you reach $5,100 in Medicare out-of-pocket drug costs for the year, you pay the lower of:

  • Your GIC copay, or
  • Medicare’s Catastrophic Coverage, which is the greater of
    • 5% of the cost, or
    • $3.40 copay for generic, including brand drugs treated as generic, or
    • $8.50 copay for all other drugs

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1 The typical number of days after the mail order pharmacy receives an order to receive your shipment is up to 10 days. Enrollees have the option to sign up for automated mail order delivery. If your mail order drugs do not arrive within the estimated time frames please contact us toll-free, 24 hours a day, 7 days a week. Our contact information is listed under the “Contact Us” tab above.


  • Have Questions? 1-877-876-7214
  • Call us toll-free, 24 hours a day, 7 days a week. TTY users call 711
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