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 one of five plan options which offer different combinations of copays and coinsurance amounts.
|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|
$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 25% (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 $5,100 (2017)
- After a member's yearly out-of-pocket costs reaches $5,100 (2017) (the amount a member pays for covered drugs in a calendar year) catastrophic coverage begins and members pay the greater of $3.40 per copay for generic or multi-sourced preferred brand drugs, and $8.50 (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 documents and information:
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 Bradley Larson|
|Montana||Email Rhonda Nordahl|
|Nebraska||Email Joni Olds|
|North Dakota||Email Chris Kulesa|
|South Dakota||Email Lynn Tague|
|Wyoming||Email Lee Shannon|
Regulatory notice for and contact information for Group MedicareBlue Rx
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 1-800-772-1213 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 may cover prescriptions filled at out-of-network pharmacies in limited situations. Members that use an out-of-network pharmacy, will generally have to pay the full cost (rather than your normal share of the cost) at the time you fill your prescription. You can ask us to reimburse you for our share of the cost.
For more information about mail-order service or to obtain additional network pharmacy information call Group 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
Group Customer Service at the phone numbers listed above 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 Part A and/or enrolled in Medicare Part B, live in the plan’s service area and are identified as an eligible plan participant by your employer.
- You must continue to pay your Medicare Part B premium, and Medicare Part A if applicable, if not otherwise paid for by Medicaid or another third party.
- You may enroll in only one Part D plan at a time.