A Trusted Partner in Times of Change Regulatory Notice
Blue Cross and Blue Shield has been helping organizations with Medicare solutions for decades. We offer group prescription drug plans that provide specially designed options for your Medicare-eligible retirees.
Group MedicareBlue Rx
Covers prescription drugs only. Can be offered with a medical-only plan to offer complete coverage to retirees.
Group MedicareBlue Rx offers Medicare Part D prescription drug coverage. Five standard options can be offered to your retirees as stand-alone plans or paired with your current group medical plan to create a complete solution.
Copays and coinsurance options
Choose from different copay or coinsurance amounts. You may choose one of the plan options below.
|Formulary tier:||Tier 1: Generic||Tier 2: Preferred Brand||Tier 3: Non-Preferred Brand||Tier 4: Specialty|
|Plan option: $0/$20/$40/$60||$0 copay||$20 copay||$40 copay||$60 copay|
|Plan option: $5/$15/$35/$60||$5 copay||$15 copay||$35 copay||$60 copay|
|Plan option: $10/$25/$40/25%||$10 copay||$25 copay||$40 copay||25% coinsurance|
|Plan option: $10/$25/$60/25%||$10 copay||$25 copay||$60 copay||25% coinsurance|
|Plan option: $10/$30/$50/$50 (GEN) *||$10 copay||$30 copay||$50 copay||$50 copay|
- Members pay no more than the $10 copay for Tier 1: Generic Drugs.
- Members generally pay no more than 40% (2017) of the plan's costs for brand-name drugs.
Our plans offer:
- No annual deductibles so coverage starts right away.
- Find a plan that fits your budget and retirees' needs with several cost sharing options.
- Most Group retirees have coverage through the coverage gap, also called the "donut hole."
- They pay no more than the usual cost sharing for generic and brand-name drugs.
- Generally they pay less because of the manufacturer discount program for brand-name drugs.
- Catastrophic coverage begins once total out-of-pocket costs reach $4,950 (2017)
- After a member's yearly out-of-pocket costs reaches $4,950 (2017) (the amount a member pays for covered drugs in a calendar year) catastrophic coverage begins and members pay the greater of $3.30 (2017) per copay for generic or multi-sourced preferred brand drugs, and $8.25 (2017)per copay for all other covered drugs or 5 percent of the cost of covered drugs
- Each plan option also includes supplemental drugs with a 25 percent coinsurance (supplemental drug costs do not count toward the out-of-pocket maximum).
Group Formulary Documents:
To find out more about our plans for employer and union groups, talk with your authorized independent agent/broker or the licensed Blue Cross and Blue Shield sales representative in your state:
|Iowa||Email Lynn Tague|
|Minnesota||Email Joel Stich|
|Montana||Email Rhonda Nordahl|
|Nebraska||Email Joni Olds|
|North Dakota||Email Jack Easton|
|South Dakota||Email Lynn Tague|
|Wyoming||Email Lee Shannon|
Regulatory Notice for Group MedicareBlue Rx page top
Customer Service 1-877-838-3827
TTY hearing impaired users call: 711
8 a.m. to 8 p.m., daily, Central and Mountain Times
Group MedicareBlue Rx
Coverage is available to members of an employer or union group and separately issued by one of the following plans: Wellmark Blue Cross and Blue Shield of Iowa,* Blue Cross and Blue Shield of Minnesota,* Blue Cross and Blue Shield of Montana,* Blue Cross and Blue Shield of Nebraska,* Blue Cross Blue Shield of North Dakota,* Wellmark Blue Cross and Blue Shield of South Dakota,* and Blue Cross Blue Shield of Wyoming.*
* Independent licensees of the Blue Cross and Blue Shield Association.
You may be able to get extra help to pay for your prescription drug premiums and costs. To see if you qualify for getting extra help, call:
- 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/7 days a week; or
- The Social Security Office at 1-800-722-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users call 1-800-325-0778; or
- Your State Medicaid Office.
Group MedicareBlue Rx members must use contracted network pharmacies to access their prescription drug benefit, except under non-routine circumstances when they cannot reasonably use network pharmacies. Types of network pharmacies include: retail, mail order, long-term care, and Indian/Tribal/Urban.
For more information about mail-order service or to obtain additional network pharmacy information call Customer Service.
Or send a request in writing to:
Group MedicareBlue Rx Customer Service, P.O. Box 3178, Scranton, PA 18505.
If you have special needs, this document is available in alternative formats. Please call Customer Service at the phone numbers listed below for more information.
Group MedicareBlue Rx
Group MedicareBlueSM Rx (PDP) is a Medicare-approved Part D sponsor. Enrollment in Group MedicareBlue Rx depends on renewal of the plan sponsor's contract with Medicare.
- You are eligible to enroll in Group MedicareBlue Rx if you are entitled to Medicare benefits under Part A or enrolled in Medicare Part B and live in the plan service area.
- You must continue to pay your Medicare Part B premium if not otherwise paid for under Medicaid or by another third party.
- You may be enrolled in only one Part D plan at a time. If you are enrolled in a Medicare Advantage plan, you may not join Group MedicareBlue Rx unless you are a member of a Private-Fee-For-Service MA plan (PFFS) that does not provide Medicare prescription drug coverage, a Medicare Savings Account MA plan (MSA), or an 1876 Cost Plan.