Clear Spring Health Medicare Part D 2024 Review

Clear Spring Health is the eighth-largest company offering Medicare Part D plans. About 345,000 Medicare beneficiaries have Clear Spring Health Medicare Part D plans as of September 2024^[0]

Clear Spring Health can’t currently advertise or sell Medicare Part D plans to new members. Because Clear Spring’s Part D plans have had very poor quality ratings for three consecutive years, the Centers for Medicare & Medicaid Services (CMS) sanctioned the company. Its Part D plans will be terminated at the end of 2024.

Here’s what you need to know about Clear Spring Health Medicare Part D prescription drug plans.

Clear Spring Health Medicare Part D star ratings

Average Part D star rating, weighted by enrollment: 1.5 stars

The Centers for Medicare & Medicaid Services rates Medicare Part D plans on 12 quality measures^[0]

These ratings use a 5-point scale where 5 is the best and 1 is the worst. The agency bases its ratings on drug plans’ quality of service and customer experiences, and ratings are updated annually^[0]

Based on the most recent year of data, stand-alone Clear Spring Health prescription drug plans get an average rating of 1.5 stars, weighted by enrollment^[0]

Medicare Part D plans are required to maintain a summary rating of at least 3 stars to remain in good standing. Because Clear Spring Health has fallen below this threshold for three consecutive years, the company has been sanctioned by CMS, and its Medicare Part D contract will end at the end of 2024^[0]

» MORE: Medicare star ratings: How they can help you choose a plan

Clear Spring Health Medicare Part D prescription drug plans

Medicare beneficiaries with Original Medicare (Part A and/or Part B) can purchase a Medicare Part D plan for prescription drug coverage. Part D plans are sold by private insurance companies. The costs and coverage can vary significantly, so it’s important to compare options.

Whereas other companies offer as many as three options, Clear Spring Health has only one Medicare Part D plan in 2024: Clear Spring Health Value Rx^[0]

But right now, new members can’t enroll in a Clear Spring Medicare Part D plan. As of Oct. 29, 2023, CMS has prohibited Clear Spring from marketing its Part D plans or enrolling new members due to poor quality ratings.

Members already enrolled in a Clear Spring Medicare Part D plan can choose to keep their coverage until the end of 2024 — but they might want to shop for a better plan before then.

Clear Spring Health Medicare Part D cost

Clear Spring Health Medicare Part D premiums and deductibles

Clear Spring Health offers only one Medicare Part D plan in 2024, down from two in 2023.

Premiums for the Clear Spring Health Value Rx plan are down a few dollars for 2024, on average. The deductible has gone up to meet the maximum that plans are allowed to charge in 2024: $545.

Here are the 2024 premiums and deductibles for Clear Spring Health’s stand-alone Medicare prescription drug plan^[0]

» If you have concerns about affording Medicare Part D, look into Medicare Extra Help.

$0-deductible options

There are no $0-deductible options from Clear Spring Health in 2024. The $545 deductible for the Clear Spring Health Value Rx plan applies to drugs on all tiers^[0]

» MORE: What is a Medicare Part D formulary?

$0-copay options

There are no $0-copay options from Clear Spring Health for 2024. But drugs on Tier 1 and Tier 2 cost $1 and $3, respectively, for a 30-day supply from a preferred pharmacy^[0]

Copay vs. coinsurance requirements

You’ll want to check whether you’ll pay a copay or coinsurance for your medications. Copays are set dollar amounts, so it’s easy to see what you’ll pay. Coinsurance is a percentage of the price for your medications, so coinsurance requirements can be more unpredictable and more expensive.

The Clear Spring Health Value Rx plan has copays for Tiers 1-3 and coinsurance for Tiers 4-5^[0]

» MORE: How much does Medicare Part D cost?

Clear Spring Health Medicare Part D service area

Stand-alone Medicare prescription drug plans from Clear Spring Health are available in Washington, D.C., and every state except New York^[0]

Clear Spring Health offers its single Medicare Part D plan in all of its markets for 2024 (for existing members only while the company is barred from enrolling new members).