Explore the Standard and Premier plan benefits for 2020

Original Medicare will help you cover medical costs, but when it comes to your prescription drugs, you may need more coverage. MedicareBlue Rx is a Medicare prescription drug plan backed by Blue Cross and Blue Shield that can help you manage your prescription costs. We offer two plan options – Standard and Premier – so you can find the coverage that best fits for your needs.

MedicareBlue Rx offers:

  • Coverage for generic, brand name and specialty drugs
  • Two plan options – Standard and Premier
  • A nationwide pharmacy network
  • Lower prescription costs at thousands of preferred pharmacies, including Walmart, CVS and Thrifty White Pharmacy
  • Reliable Blue Cross and Blue Shield coverage
  • Coverage that can be paired with Original Medicare and a Medicare supplement insurance (Medigap) plan
  • Prescription mail order service through CVS Caremark1

Compare the benefits of the MedicareBlue Rx Standard and Premier plans below to find a plan that's right for you.

Benefits

MedicareBlue Rx Standard

MedicareBlue Rx Premier

Monthly plan premium
amount you pay

$42

$89.60

Annual deductible – amount you pay before initial coverage begins $0 on tier 1 (preferred generic) and tier 2 (generic) drugs
$435 on tier 3 (preferred brand), tier 4 (non-preferred drug) and tier 5 (specialty) drugs

$0

Initial coverage – amount you pay for a 30-day supply

Preferred
cost sharing

After you pay the applicable deductible

Standard
cost sharing

After you pay the applicable deductible

Preferred
cost sharing

Standard
cost sharing

Tier 1: Preferred
generic drugs
$3 copay $15 copay $0 copay $15 copay
Tier 2: Generic drugs $8 copay $20 copay $0 copay $20 copay
Tier 3: Preferred
brand drugs
$29 copay $46 copay 17% coinsurance 25% coinsurance
Tier 4: Non-preferred drugs 29% coinsurance 35% coinsurance 40% coinsurance 45% coinsurance
Tier 5: Specialty drugs 25% coinsurance 25% coinsurance 33% coinsurance 33% coinsurance
Coverage gap – amount you pay for a 30-day supply after your total yearly covered prescription drug costs reach $4,020 1   Tier 1 (preferred generic) and tier 2 (generic) drug costs are the same as those listed above

• Generic drugs: 25% of the plan cost
• Brand-name drugs: 25% of the plan cost
For drugs in all other tiers:
• Generic: 25% of the plan cost
• Brand-name: 25% of the plan cost
Catastrophic coverage – amount you pay for a 30-day supply after you have paid $6,350 in out-of-pocket prescription drug costs 2 For both plans, you pay the greater of:
• 5% of the cost, or
• a $3.60 copay for generic drugs (including brand drugs treated as generic) and a $8.95 copay for all other drugs

1 Your "total drug costs" means the total amount you have paid for covered drugs plus what the plan has paid for the calendar year. This does not include the plan premium you pay.

2 Your "out-of-pocket costs" means the amount you have paid for covered drugs for the calendar year. This does not include the amount the plan has paid or the plan premium you pay.

Review 2020 plan details and fill out the enrollment form with our digital enrollment guidePDF icon.

About the MedicareBlue Rx Standard plan

The Standard plan has a $0 deductible on tier 1 and 2 drugs, so coverage starts right away with copays or coinsurance. You will usually pay less when you use a preferred pharmacy.

This plan may be a good fit for you if you:

  • Take mostly generic drugs that are covered on tier 1 or tier 2
  • Need access to pharmacies when you travel across the U.S.

Estimate your annual costs with the Standard plan.
Refer to the Summary of BenefitsPDF icon for complete plan information.

About the MedicareBlue Rx Premier plan

The Premier plan has a $0 deductible on all 5 tiers, so your coverage starts right away with copays or coinsurance. Enjoy a $0 copay on your tier 1 and tier 2 prescriptions when you use a preferred pharmacy. Plus, get extra coverage during the coverage gap stage on tier 1 and tier 2 prescriptions.

This plan may be a good fit for you if you:

  • Take multiple generic and/or brand-name drugs
  • Need access to pharmacies when you travel across the U.S.
  • Need extra coverage in the coverage gap stage

Estimate your annual costs with the Premier plan.
Refer to the Summary of BenefitsPDF icon for complete plan information.

1CVS Caremark Part D Services is an independent company providing pharmacy benefit management services.