Plan Options

• MedicareBlue PPO
  • 2008 Benefits at a Glance (PDF)
  • 2008 Enrollment Guide (PDF)
  • 2008 Summary of Benefits (PDF)
  • 2008 Evidence of Coverage
  • Prior Authorization
  • Quantity Limits
  • Questions & Answers
  • Complaints & Appeals (PDF)
  • Request Information
  • Enroll Now
• MedicareBlue Rx
  • 2008 Benefits at a Glance (PDF)
  • 2008 Enrollment Guide (PDF)
  • 2008 Summary of Benefits (PDF)
  • 2008 Evidence of Coverage
  • Pharmacy Benefit Manager
  • Complaints & Appeals (PDF)
  • Questions & Answers
  • Request Information
  • Prior Authorization
  • Quantity Limits
  • Step Therapy
  • Enroll Now
• Medicare Supplement Plans & Other Options
• Group Plans

MedicareBlue Rx

Quantity Limits

MedicareBlue Rx covers a 31-day supply for retail prescriptions (or up to a 90-day supply at certain retail pharmacies or through mail order). In addition, some prescriptions are limited to a specified maximum quantity. Amounts over this quantity are not a covered benefit unless approved in advance by the plan.

Quantity limits are in place for these drugs to ensure the medication is being used correctly and other treatments are not more appropriate. Most people would not need to take these drugs more often than what is allowed.

No special steps are necessary by the physician or member to have these drugs covered as long as the medications are prescribed within the limitations. If you require one of these drugs in a larger quantity than is allowed, your physician may request an exception to have a larger quantity of the drug covered An exception is a type of coverage determination. For more information, follow the link to find the Coverage Determination/Redetermination form.

You may search the drug formulary now to find out if your drug has a quantity limit.