MedicareBlue Rx 2018

Your choice for drug coverage

Prescription drugs can be expensive. MedicareBlue Rx is a Part D Prescription Drug Plan designed to help you manage your drug costs. Even if you don’t have drug costs now, this plan can protect you from the expense of prescription drugs you may need in the future.

MedicareBlue Rx offers you:

  • Protection from unexpected drug costs
  • Coverage of preferred and non-preferred generic and brand-name drugs, as well as specialty drugs
  • Access to a nationwide network of pharmacies that include major chains as well as neighborhood pharmacies. You can also search our drug list (formulary) to see if your medications are covered.

Choose from two plan options

We offer two plan options — Standard and Premier. Both plans offer preferred cost sharing.

  • Our Standard option has a $0 deductible on Tiers 1 & 2 drugs and a $405 deductible on Tiers 3, 4 and 5 drugs that you must pay first before copay or coinsurance cost sharing begins.
  • Our Premier option does not have a deductible, so drug coverage starts right away with copays or coinsurance. Our Premier option also offers additional savings on generic drugs in the coverage gap.
  • Each option includes catastrophic coverage that helps protect against high drug costs after you have spent a certain amount on prescription drugs.

See below to compare the two options at each coverage stage.

Benefits

MedicareBlue Rx Standard

MedicareBlue Rx Premier

Monthly plan premium

amount you pay

$37.40

$100.60

Annual deductible – amount you pay before initial coverage begins

$0 on Tier 1 (Preferred Generic) and Tier 2 (Generic) drugs; $405 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

Tier 2: Generic drugs

Tier 3: Preferred
Brand drugs

Tier 4: Non-Preferred drugs

Tier 5: Specialty drugs

• $1 copay


• $5 copay

• 17% coinsurance


• 30% coinsurance

• 25% coinsurance

• $15 copay


• $19 copay

• 21% coinsurance


• 41% coinsurance

• 25% coinsurance

• $0 copay


• $0 copay

• 17% coinsurance


• 45% coinsurance

• 33% coinsurance

• $15 copay


• $20 copay

• 25% coinsurance


• 50% coinsurance

• 33% coinsurance

Coverage gap – amount you pay for a 30-day supply after your total yearly covered prescription drug costs reach $3,7501


• Generic drugs


• Brand-name drugs





• 44% of the plan’s costs


• 35% of the plan’s costs

• $0 copay for Tier 1: Preferred Generic drugs, $0 copay for Tier 2: Generic drugs

• $15 copay for Tier 1: Preferred Generic drugs, $20 copay for Tier 2: Generic drugs

• 44% of the plan’s costs for all other generic drugs

• 35% of the plan’s costs for all other brand-name drugs

Catastrophic coverage – amount you pay for a 30-day supply after you have paid $5,000 in out-of-pocket prescription drug costs2

The greater of $3.35 copay for generic drugs and $8.35 copay for all other covered drugs OR 5% coinsurance

1Your “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.

2Your “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.

2018

To help you decide which plan is right for you, use our cost estimator. Remember to compare all the benefits and value offered by each plan option, in addition to out-of-pocket costs.

If you are new to Medicare, you may want to learn more about Medicare before choosing a plan.

Rates and coverage details

For plan rates and what's covered in each option, refer to the:

Order printed materials online at no cost to you

Place your order for printed materials, including an enrollment kit (and more depending on location). Orders are mailed free of charge.

Use our pharmacy network for the greatest benefits

Once enrolled in MedicareBlue Rx, you’ll have access to a nationwide network of pharmacies that include major chains as well as neighborhood pharmacies. You may go to any of our network pharmacies. However, your costs may be even less for your covered drugs if you use a network pharmacy that offers preferred cost sharing rather than a network that offers standard cost sharing.

In most cases, your prescriptions are covered only if they are filled at one of our network pharmacies. If you go to a pharmacy that is not in our network, you may have to pay more for your prescriptions and you may have to file a claim to be reimbursed. You will pay any difference between the non-network pharmacy’s charge and the amount the plan allows. Some drugs may have  quantity limits or other restrictions that apply.

MedicareBlue Rx is awarded a 5 (out of 5) Star rating for 2017

MedicareBlue Rx has been awarded a 5-Star rating* from the Centers for Medicare & Medicaid Services (CMS) for 2017. This is the highest possible score, which is why MedicareBlue Rx continues to be a top choice for members focused on quality.

The Star Rating System rates plans on the results of several quality measures, with the summary score providing a measure of a plan's overall quality. This score represents the quality of care, access to care, responsiveness of the plan and the members' satisfaction. Plans with five stars represent "excellent performance." Both Medicare Advantage and Prescription Drug plans are rated using the system.

If you would like additional information on our plan's performance, please contact us at
1-866-434-2037 (TTY hearing impaired users call 711), 8 a.m. to 8 p.m., daily, Central and Mountain Times, or visit medicare.gov.

* Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next.

Once you join our plan

When you join MedicareBlue Rx you may receive an occasional letter from the plan. For example, if you have other prescription drug coverage, you may receive a letter asking that you verify your other coverage so that Medicare can coordinate your benefits with your other plan coverage.

You will receive a letter from the plan shortly after your enrollment application is received if an agent helped with your enrollment. Its purpose is to make sure you are enrolled in the correct plan, describe how the plan works and answer any questions you may have.

If you have any questions about letter or phone call you receive from the plan, please call 1-888-832-0075 (TTY hearing impaired users call 711).

Medication Therapy Management (MTM) Program

If you meet certain requirements, you may be invited to participate in a program designed for your specific health and pharmacy needs. You may choose not to participate, but it is recommended that you take full advantage of this service if you are selected. Find out more about the program including who is eligible for MTM.