Call 1-855-871-5294
TTY 1-866-684-5351
7 days a week, 8 am to 8 pm

Our specialists may help you save money
on your prescriptions.

1-855-871-5294 TTY 1-866-684-5351 7 days a week, 8 am to 8 pm
You may be able to get more and spend less
for your Medicare prescription drug plan.
$0 to $2 copays1 on Tier 1 generic and brand drugs
Nationwide network of over 65,000 pharmacies2
Low premiums
Helpful support
Annual Enrollment Period for the 2012
Plan Year Ends December 7, 2011 Compare Our
Plans & Rates Let us help you find the right plan for you.
Plans vary by region.

Community CCRxSM Choice Plan (PDP) and Community CCRxSM Basic Plan (PDP) are federally-qualified Medicare contracting Prescription Drug Plans.

Community CCRxSM Choice Plan (PDP) and Community CCRxSM Basic Plan (PDP) are offered by SilverScript® Insurance Company in New York, and Pennsylvania Life Insurance Company in all other states, the District of Columbia and the U.S. Virgin Islands.

1The $0 copay applies to up to a 30-day supply of a Tier 1 drug for Community CCRx Choice Plan (PDP) during the Initial Coverage Stage (ICS), which for this plan begins on the first day of coverage. The $2 copay applies to up to a 30-day supply of a Tier 1 drug for Community CCRx Basic Plan (PDP) during the ICS, which for this plan begins once the deductible is met.

2Community CCRxSM Choice Plan (PDP) and Community CCRxSM Basic Plan (PDP) Internal Report dated 9/1/2011.

The benefit information provided herein is a brief summary, not a comprehensive description of benefits. For more information contact the plan. You must continue to pay your Medicare Part B premium. Limitations, copayments, and restrictions may apply. Members may enroll in the plan only during specific times of the year. You must use network pharmacies to access your prescription drug benefit, except under non-routine circumstances, and quantity limitations and restrictions may apply. Contact the plan for more information by calling 1-866-684-5353 (TTY users call 1-866-684-5351), 8:00 a.m. to 8:00 p.m., 7 days a week. If you would like information on other plans visit www.Medicare.gov. You may be able to get Extra Help to pay for your prescription drug premiums and costs. To see if you qualify for extra help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/7 days a week; or the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or your State Medicaid Office.

Y0080_Web_KBM2_5803_5825_0811 (CMS Approved 10/26/2011) Last Updated 10/03/2011