MedicareBlue Rx 2014

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:

Choose from two plan options

We offer two plans options — Standard and Premier. Our Standard option has a low deductible you must pay first, then you pay copays and coinsurance for your drugs. Our Premier option does not have a deductible, so coverage starts right away with copays and coinsurance for your drugs. See below to compare the two options at each coverage stage. Both plans include catastrophic coverage that helps protect against high drug costs after you have spent a certain amount on prescription drugs.

2014 Benefits

MedicareBlue Rx Standard

MedicareBlue Rx Premier

Annual deductible – amount you pay before initial coverage begins $160 $0
Initial coverage – amount you pay for a 31-day supply
  • Tier 1: Preferred Generic drugs

  • Tier 2: Non-Preferred Generic drugs

  • Tier 3: Preferred Brand drugs

  • Tier 4: Non-Preferred Brand drugs
After you pay the deductible:

    $ 4 copay

    $ 18 copay

    $ 38 copay

    48% coinsurance
After you pay the deductible:

    $ 3 copay

    $ 8 copay

    $ 35 copay

    45% coinsurance
Coverage gap – amount you pay for a 31-day supply after your yearly covered prescription drug costs reach $2,850
  • Generic drugs

  • Brand drugs

    72% of the plan's costs

    No more than 47.5% of the plan's costs

    $ 3 copay for Tier 1: Preferred Generic drugs and $ 8 copay for Tier 2: Non-Preferred Generic drugs; 72% of the plan's costs for all other generic drugs

    No more than 47.5% of the plan's costs for brand-name drugs
Catastrophic coverage – amount you pay for a 31-day supply after you have paid $4,550 in out-of-pocket prescription drug costs The greater of $2.55 copay for generic drugs and $6.35 copay for all other covered drugs OR 5% coinsurance The greater of $2.55 copay for generic drugs and $6.35 copay for all other covered drugs OR 5% coinsurance

To help you decide which plan is right for you, use our drug calculator. Remember to compare all the benefits and value offered by each plan, 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, refer to the:

You can also request this information be mailed to you.

Use our pharmacy network for the greatest benefits

Once enrolled, you’ll have access to more than 64,000 network pharmacies, including major chains such as Target, Wal-Mart or Walgreens and many neighborhood pharmacies. Using a pharmacy in our network reduces your costs and your claims will be filed for you.

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 apply.


MedicareBlue Rx achieves 4-Star Rating for 2014

MedicareBlue Rx earned a four-Star Rating from the Centers for Medicare & Medicaid Services (CMS) for 2014. A four-Star Rating is the highest overall quality score any prescription drug plan (PDP) in the region earned, so MedicareBlue Rx continues to be a top choice for members looking for quality. The final version of the Star Ratings is available by clicking the  2014 MedicareBlue Rx Star Ratings PDF document link. 

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

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 member’s 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


Phone calls once you join our plan

When you join MedicareBlue Rx you may receive an occasional phone call from the plan. The first phone call will occur shortly after your enrollment application is received by the plan if an agent helped with your enrollment. Its purpose is to describe how the plan works and answer any questions you may have. You may occasionally receive other calls from the plan. For example, if you have other prescription drug coverage, you may receive a call asking that you verify your other coverage so that Medicare can coordinate your benefits with your other plan coverage.

If you have any questions about a phone call you receive from the plan, please call 1-866-434-2037 (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. For more about who is eligible for MTM and how the program can help you, see the program flyer PDF document.

You can also download a blank Personal Medication List to get started.