Express Scripts (Cigna) offers three Medicare Part D prescription drug plans, among other services.
Express Scripts Medicare Part D plans range in cost from low premiums and low copays to broad coverage and a low deductible.
This article looks at Express Scripts Medicare prescription drug plans in more detail, including the costs and eligibility.
Glossary of Medicare terms
We may use a few terms in this article that can be helpful to understand when selecting the best insurance plan:
- Out-of-pocket costs: An out-of-pocket cost is the amount a person must pay for medical care when Medicare does not pay the total cost or offer coverage. These costs can include deductibles, coinsurance, copayments, and premiums.
- Deductible: This is an annual amount a person must spend out of pocket within a certain period before an insurer starts to fund their treatments.
- Coinsurance: This is the percentage of treatment costs that a person must self-fund. For Medicare Part B, this is 20%.
- Copayment: This is a fixed dollar amount a person with insurance pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
Express Scripts have been around since their founding in 1986. Cigna acquired them in 2018, and they became part of Evernorth in 2020. Among other services, the company offers three Express Scripts Medicare prescription drug plans.
Formulary
Each Express Scripts prescription drug plan includes a list, called a formulary, of the drugs that the plan covers. The formulary sets these drugs out in five or six tiers, depending on the plan. Tier 1 usually includes the least expensive generic drugs, while the most expensive brand-name drugs are in the highest tier.
Pharmacists
With the Express Script prescription drug plan, a person can choose which pharmacy to use. They can choose between home delivery and retail pharmacies.
Federally funded Medicare is a health insurance program for people over 65 years old in the United States. Some younger people with disabilities also qualify for Medicare.
The program consists of four main parts:
Read about Original Medicare vs. Medicare Advantage.
Private companies offer Medicare Part D prescription drug plans, which first became available in 2006.
Plan costs vary, as does the list of covered drugs. Each Part D plan has a formulary that lists all of the drugs that it covers, including generic and brand name options.
Costs
For 2024, the basic Part D premium is $34.70. Additional costs include out-of-pocket expenses, such as the annual deductible, copays, or coinsurance.
Other factors that may affect overall costs include the tier in which the drug sits and whether it is a generic or brand-name medication.
In addition, a person must pay the plan deductible, after which they will pay a maximum of 25% of the cost of either generic or brand-name drugs, up to a total of $5,030.
Once a person’s out-of-pocket drug costs total $8,000, they reach catastrophic coverage. Once a person reaches catastrophic coverage, they will pay nothing for their prescription drugs for the rest of the year.
Express Scripts (Cigna) offers three plans, each with different benefits and costs. The chart below shows some of the plans’ costs:
| Plan | Premium | Deductible | Out-of-pocket maximum |
|---|---|---|---|
| Saver | From $5.70 in Hawaii to $24.10 in Louisiana | $0 for generic drugs in tiers 1 and 2 and select insulins in tier 3, and $545 for all other drugs | $5,030 |
| Secure | From $31.30 in Maine to $78.60 in Hawaii | $545 for all drug tiers | $5,030 |
| Extra | From $61.90 in Alaska to $116.30 in Hawaii | •$0 for tiers 1 and 2 •$145 for tiers 3, 4, and 5 | $5,030 |
This online tool will help a person check for available Express Scripts (Cigna) prescription drug plans by zip code.
A person must also pay the Medicare Part B premium, which is $174.70 in 2024 for a person with an annual income of $103,000 or less. A person with a higher annual income may pay higher premiums.
A person enrolled in Original Medicare (Part A and Part B) is eligible to get a Part D drug prescription plan. They can get this alongside their Original Medicare plan or enroll in a Medicare Advantage (Part C) plan with prescription drug coverage.
Enrollment in a Part D plan is optional, but if a person chooses to enroll at a later date, there may be penalties. If a person has alternative coverage, such as through an employer, or is in receipt of Extra Help, they may not incur a late enrollment penalty.
All companies offering the plans must provide a basic level of coverage, although costs vary among plans.
Learn about Medicare late enrollment penalties.
Medicare resources
For more resources to help guide you through the complex world of medical insurance, visit our Medicare hub.
Express Scripts (Cigna) offers three Medicare Part D prescription drug plans: Saver, Value, and Choice. Each plan has a 3-star rating with Medicare.
Premiums and other costs for Express Scripts prescription drug plans depend on the individual plan and the person’s location.