Aetna’s SilverScript Choice, a stand-alone Medicare drug plan sold in Iowa, ends on December 31. Iowa’s Senior Health Insurance Information Program says members who do nothing will have no drug coverage when 2027 begins. The plan is listed under its federal number, S5601-050.
Open enrollment for 2027 runs from October 15 to December 7. For people in a plan that is ending, the state’s Medicare counselors set the outer limit at the end of the year, so the safest course is to choose well before it.
What ending means for SilverScript Choice members
SHIIP’s 2027 changes page lists SilverScript Choice among the Part D plans not offered next year. Part D is the part of Medicare that pays for prescriptions, and people with Original Medicare buy it as a separate plan from a private insurer. The page says SilverScript Choice members must select new Medicare drug coverage by the end of the year or they will not have it at the start of 2027.
The same page treats another Iowa drug plan differently. Members of HealthSpring Extra Rx are moved automatically to a sister plan. No automatic replacement is named for SilverScript Choice, so each member has to pick one. Anyone unsure whether a letter concerns a drug plan or a health plan can match the plan name and number to SHIIP’s list, which also covers eight canceled Medicare Advantage plans and several county cuts.
Anyone who gets medicines through SilverScript Choice should set the plan’s letter beside a current list of every prescription, with doses and the pharmacy used. Each 2027 plan has its own drug list, pharmacy network and monthly premium, and a medicine that was cheap this year can cost far more under another plan. That list is what makes a comparison on Medicare’s plan finder meaningful.
What changed this year: Social Security and Medicare change every year, and nobody sends you a memo. The Retirement Money Brief breaks down what changed and what to do. Bonus when you subscribe: our Prescription Coverage & Pharmacy Checklist.
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The cost of going without drug coverage
Medicare attaches a penalty to long gaps. Medicare.gov says a person may owe a Part D late enrollment penalty after a stretch of 63 or more days in a row without Medicare drug coverage or other creditable coverage. The penalty is 1 percent of the national base beneficiary premium, $38.99 in 2026, for each full uncovered month.
That amount is added to the monthly premium, and the page says people generally pay it for as long as they have Medicare drug coverage, even after switching plans. Anyone who receives Extra Help, the program that lowers drug costs for people with limited income, does not pay it.
Extra Help matters here for another reason. SHIIP’s 2026 Iowa plan list shows SilverScript Choice at a $29.70 monthly premium and a $615 deductible, with a $0 premium for members who get Extra Help. Members on Extra Help should look for a replacement that keeps that low premium.
Why replacement shopping takes work this year
Aetna is not leaving only Iowa. CNN’s Tami Luhby reported on October 15 that CVS’s Aetna is leaving the stand-alone drug plan market in about half of states, and that more than 1 million people nationwide are losing their Part D plans, according to a CNN report carried by KION.
The same report says no $0-premium drug plans will be available in 2027, though almost every state will have plans under $20 a month. Which of those are sold in Iowa is shown on Medicare’s plan finder, which SHIIP points to for comparing plans.
Costs are moving up on the Medicare Advantage side too. The CNN report says the average deductible for Medicare Advantage plans that include drug coverage rises 23 percent to $509 in 2027, and the average cap on in-network out-of-pocket spending rises 9 percent to $6,603. Those are enrollment-weighted national averages, not Iowa figures, but they show the direction of next year’s prices.
One change works in members’ favor. SHIIP says the expanded Medicare drug price negotiation applies lower prices automatically in 2027 for a list of added drugs, including Ozempic, Wegovy, Trelegy Ellipta, Xtandi, Ibrance and Otezla. A member who takes any of them should check how each plan prices that drug, because the plan’s own drug list and tier still set what the pharmacy counter charges.
Which drug plan fits a SilverScript Choice member’s medicines?
The open question for a member is the one in the mailbox: which plan covers the prescriptions on the list at a price that fits the budget. December 7 is the last day of the fall window, and SHIIP’s year-end deadline for ending plans leaves a little room, but a member who waits gives up the chance to fix a mistake.
Free, unbiased help is available. The Iowa Insurance Division says SHIIP-SMP has 430 trained volunteer counselors at 1-800-351-4664, that the program assists more than 55,000 Iowans a year, and that appointments fill quickly. The national line, 1-800-MEDICARE (1-800-633-4227), runs around the clock. A caller should have the plan name, the medicine list and the pharmacy ready.
Is your SilverScript Choice plan gone on January 1?
A SilverScript Choice member who does not pick a new plan starts 2027 with no drug coverage, and Medicare adds a penalty to the premium after 63 days without it. The trap is choosing fast and finding one prescription priced far higher on the new plan.
The 2027 Medicare Open Enrollment Decision Kit includes a prescription-by-plan comparison and a cost calculator spreadsheet that compares plans on cost, drugs and doctors. Part 2, the Drug and Doctor Coverage Check, walks through each medicine on the list against the plan that might replace this one.
Line up each SilverScript medicine against 2027 plans in the Medicare decision kit →
More Financial Reading
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This article was produced with the assistance of AI and reviewed by the editorial team.
David M. Keller is a finance writer based in Columbus, Ohio, covering personal finance and consumer-focused economic topics. He earned his degree in journalism from Ohio University and began his career reporting on local business and economic trends for a regional media outlet. Since then, he has contributed to a variety of online publications, focusing on clear, practical coverage of topics such as cost of living, debt, and everyday financial decision-making.
