Medicare Prescription Drug Savings and Choice Act of 2018 This bill requires the Centers for Medicare & Medicaid Services (CMS) to offer one or more Medicare-operated prescription drug plan options under the Medicare prescription drug benefit. In doing so, the CMS must: (1) negotiate prices with drug manufacturers; (2) establish an appeals process for denials of plan benefits, including the option for external review and determination by an independent entity; and (3) establish and apply a formulary and formulary incentives. In general, a Medicare-operated drug plan must meet the same requirements as apply to any other prescription drug plan.