SilverScript Customer Care: How to Get Help, What to Expect, and How to Resolve Issues Quickly

Who SilverScript Customer Care Serves and How It’s Branded Today

SilverScript is a well-known Medicare Part D prescription drug plan brand now offered under Aetna Medicare, a CVS Health company. If you’re a current or prospective SilverScript member, you’ll often see the plans referred to as “SilverScript by Aetna” or “Aetna Medicare SilverScript.” The customer care experience is integrated with Aetna Medicare’s support infrastructure and CVS Health’s pharmacy network, which means broader resources, a large pharmacy network, and established service processes.

As of 2024, SilverScript plans remain Medicare-approved Part D plans and follow Medicare’s standardized rules for coverage decisions, exceptions, and appeals. The customer care team can help with eligibility, enrollment, claims, prior authorizations, formulary questions, pharmacy network issues, mail-order setup through CVS Caremark, and grievances or appeals. Keep your member ID card handy—your card lists the fastest, most plan-specific phone number for Member Services and pharmacy help.

How to Contact SilverScript Customer Care

The most reliable way to reach the right team is to call the Member Services number on your SilverScript/Aetna Medicare ID card. Medicare plans must offer service at least 8 a.m.–8 p.m. local time, 7 days a week from October 1–March 31; from April 1–September 30, typical hours are 8 a.m.–8 p.m. local time, Monday–Friday, with after-hours/holiday voicemail and callbacks. TTY users can dial 711. If you can’t find your ID card, you can sign in to the Aetna Medicare member portal to view plan contacts or request a replacement card.

You can also get independent help 24/7 from Medicare by calling 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048. For online self-service, start at aetna-medicare.com. For mail-order and prescription management, SilverScript uses CVS Caremark; members commonly manage mail-order prescriptions through caremark.com once their account is linked to the plan.

• Website: aetna-medicare.com (plan details, provider/pharmacy lookup, secure portal)
• Member portal: aetna-medicare.com/login (view ID card, track claims, refill mail-order)
• Mail-order pharmacy: caremark.com (CVS Caremark Mail Service Pharmacy account and refills)
• Medicare help line: 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048, 24/7
• TTY/TTD access to plan lines: 711 (Telecommunications Relay Service)

What Customer Care Can Do (and How to Speed Things Up)

Member Services can verify drug coverage and tiers, check whether a pharmacy is in-network or “preferred,” start or track prior authorization requests, explain Explanation of Benefits (EOB) statements, and help you use a 90-day supply or mail order when eligible. They can reissue lost ID cards, update addresses, change primary pharmacies, and connect you to the correct team for grievances, coverage determinations, and appeals.

To reduce back-and-forth and get faster resolutions, have the following ready before you call: your member ID number, the exact drug name and strength (for example, “atorvastatin 20 mg”), your preferred pharmacy name and address, and any denial letters or case numbers you’ve received. If you’re calling about a billing issue, have the EOB month, the fill date, and the pharmacy receipt. For clinical questions (like prior authorization criteria), having your prescriber’s name, NPI if available, and phone number helps the representative coordinate with your doctor right away.

Coverage Determinations, Exceptions, and Appeals: Timelines You Can Rely On

Medicare sets strict timelines for Part D issues, and SilverScript follows them. A standard coverage determination (for example, whether a drug is covered or a tiering exception request) must be decided within 72 hours once the plan has the necessary information. If waiting could seriously jeopardize your health, you or your prescriber can request an expedited decision, which must be made within 24 hours. If the decision is not in your favor, you can appeal (a “redetermination”); standard redeterminations are due within 7 calendar days, and expedited redeterminations within 72 hours.

If you encounter a service problem that’s not about coverage (such as poor customer service or excessive wait times), you can file a grievance—generally within 60 days of the event. Keep confirmations, dates, and names of representatives; this documentation speeds review. If you’re a new member and your drug isn’t on the formulary or requires prior authorization, plans must provide a temporary “transition fill” (typically up to a 30-day supply; long-term care residents may receive longer supplies) within the first 90 days of coverage while you and your prescriber work with the plan on next steps.

Costs and 2024–2025 Policy Changes Every SilverScript Member Should Know

The Inflation Reduction Act changed many Part D cost rules that apply to SilverScript plans. Insulin covered under Part D is capped at no more than $35 for a 30-day supply, even before a deductible. ACIP-recommended adult vaccines (such as shingles/Shingrix and Tdap) are covered at $0 out of pocket under Part D when administered at an in-network pharmacy.

In 2024, the 5% coinsurance in the catastrophic phase was eliminated, reducing high-cost exposure. In 2025, out-of-pocket drug costs will be capped at $2,000 for Part D, and Medicare will offer the Medicare Prescription Payment Plan, allowing you to “smooth” payments over the year instead of paying large costs at once. Customer care can explain how to enroll in payment smoothing for 2025, how it affects monthly bills, and how to monitor progress toward your OOP cap in your EOBs.

Pharmacies, Mail Order, and Getting the Best Price

SilverScript’s network includes a broad national footprint with tens of thousands of in-network pharmacies. Many locations are “preferred” retail pharmacies, which usually offer lower copays than “standard” in-network pharmacies. Always ask customer care or check the online pharmacy finder to confirm whether your regular pharmacy is preferred for your specific plan, since networks can vary by plan and year.

Mail order through CVS Caremark can be cost-effective for maintenance medications. Typical benefits include 90-day supplies and reduced copays on select tiers, with convenient refill reminders. Customer care can help you and your prescriber set up electronic prescriptions directly to CVS Caremark. If you need a one-time urgent fill, ask about “vacation overrides” or “lost medication overrides”—these are reviewed case by case and may require documentation.

Medication Therapy Management (MTM) and Safety Programs

SilverScript participates in Medicare’s Medication Therapy Management program, which proactively supports members with multiple chronic conditions taking several medications and whose annual drug costs meet the CMS threshold. If you qualify, you’ll be invited—at no extra cost—to a comprehensive medication review (CMR) with a clinical pharmacist, usually by phone, and you’ll receive a personal medication list and an action plan you can share with your doctors.

Customer care can check your MTM eligibility, schedule your CMR, and help resolve safety alerts (drug interactions, duplicate therapy) that sometimes stop a claim at the pharmacy. If your prescription was rejected for a safety edit, have your prescriber’s contact information ready so the team can coordinate the required clarification or prior authorization.

Filing a Complaint or Getting Independent Help

If you believe your issue isn’t being resolved, ask the representative for a case number and the plan’s formal grievance or appeal address or fax line. You may request a supervisor review. Keep copies of all letters, denials, and EOBs and note the dates you called. For independent support, you can contact your State Health Insurance Assistance Program (SHIP) for free counseling; you can find your local SHIP via shiphelp.org or by calling 1-800-MEDICARE.

If you need to change plans, remember the Medicare Annual Enrollment Period runs October 15–December 7 each year, with new coverage effective January 1. Special Enrollment Periods may apply if you move, lose other creditable coverage, qualify for Extra Help, or experience certain life events. Customer care and 1-800-MEDICARE can tell you which SEP rules apply to your situation.

What to Have Ready Before You Call (Saves 10–15 Minutes Per Issue)

• Member ID card, full name, date of birth, and address exactly as listed on the card and on file
• Prescription details: drug name, dosage, quantity, days’ supply, and the prescribing provider’s name and phone
• Pharmacy details: pharmacy name, full address, and phone; note if it’s your preferred store
• Documentation: denial letters, case numbers, prior authorization IDs, and the date/time of any previous calls
• Billing references: month of the EOB, claim number, and the amount you were charged at the counter

Bottom Line

SilverScript customer care, delivered through Aetna Medicare and supported by CVS Health’s pharmacy network, can resolve most benefit and pharmacy issues quickly if you call with precise information. Use the number on your ID card for the fastest route, rely on Medicare’s standardized timelines for determinations and appeals, and leverage cost-saving programs like preferred pharmacies, mail order, and the new 2025 payment smoothing to keep your out-of-pocket costs predictable. If you need independent assistance at any point, 1-800-MEDICARE is available 24/7 to help you understand your rights and options.