BlueRx Option II Prescription Plan for Alabama Medicare Beneficiaries
| Overall Plan Rating: |  |
|---|---|
| Monthly Premium: | $91.60 |
| Pharmacy Co-Pay: | $0.00 |
| Coverage Limit (ICL): | $2,970.00 |
| Pharmacy Mail Order: | Yes |
| Gap Coverage: | No Gap Coverage |
| Low Income Subsidy: | No |
| Medicare Formulary: | 3656 |
| PDP ID No: | S1030-001 |
| Plan Year: | 2013 |
| Approved by CMS for: | AL Residents |
| Rx Plan Type: | Regional |
| Est. Regional Members: | 21532 |
2018 Medicare Prescription Medication Plan Overview
BlueRx Option II (PDP) is an approved Medicare Prescription Drug Plan (Part D) for Alabama seniors.
The annual premium is $1,099.20 ($91.60 monthly), and it carries a $0.00 deductible on all prescribed medications. Since it has a zero dollar deductive, you have coverage from the first dollars spent. Note that many plans have a policy deductible that must be paid in full prior to receiving prescription coverage assistance.
The Blue Cross and Blue Shield of Alabama formulary ID for this plan is 00012208, and it features 3656 FDA approved medications.
For all Alabama seniors with Medicare benefits, there are two conditions that can change the amount you pay for your plan. The first is quailfying for the Extra Help program, which lowers your premium. The second is the opposite: if a premium penalty has been imposed on you for not enrolling right away at age 65 open enrollment, then your premium will be marginally higher.
Below are a few plans that are comparable to BlueRx Option II:
- WellCare Classic at $36.10 per month for Alabama Seniors
- First Health Part D Premier Plus at $102.50 per month for Alabama Seniors
- Humana Enhanced at $47.10 per month for Alabama Seniors
BlueRx Option II Initial Coverage
In the ICP (Initial Coverage Phase) the cost of your prescriptions is shared with your insurance company. You and the carrier each pay your share (as determined by the plan) until you reach the Initial Coverage Limit (ICL). In 2013, the ICL is $2,970 and this number changes each year. No deductible means your initial coverage phase begins immediately.
Each prescription medication is put into a tier within each Medicare Part D plan's drug formulary. Different tiers have different levels of cost-sharing. It's important to note that these tiers are not completely standardiszed and your prescriptions may be found in different tiers on differnt plans. This is why we provide access to all Part D plans' drug formularies, so you can compare what the cost is for your prescription drugs for different Part D plasn in your area.
The pharmacy co-pay with the BlueRx Option II (PDP) plan in Alabama is tiered as follows:
| Tier | Co-Pay Amount | Medications in Tier |
|---|---|---|
| 1 | $4.00 | 1686 Preferred Generics |
| 2 | $40.00 | 370 Non-Preferred Generics |
| 3 | $65.00 | 1358 Preferred Brands |
| 4 | 33% | 242 Non-Preferred Brands |
| 5 | 0 Specialty Medications | |
The Initial Coverage Limit (ICL) is $2,970.00. This prescription plan does not qualify for the $0 LIS premium.
BlueRx Option II (PDP) 2013 Coverage Gap
The Coverage Gap (aka, "Donut Hole") is the coverage phase where you must pay all of your medication costs. Some plans provide donut hole coverage, and if you think that your drug costs will be high enough to get to this level, you should consider a plan with donut hole coverage. You can learn more about costs in the donut hole by reading What is the Medicare Part D Donut Hole? How long it will take you to reach the donut hole with the BlueRx Option II (PDP) plan depends on your specific prescriptions.
The Gap Coverage with this policy: You must pay the $3727.50.
Plan Members
Nationwide, the number of seniors using the BlueRx Option II policy is 21,532. In region 12 (your region) there are approximately 21,532 people with this policy (based on 2011 CMS statistics).
More Information About Blue Cross and Blue Shield of Alabama
Blue Cross and Blue Shield of Alabama administers health and dental programs for over 3 million individuals throughout the state of Alabama and around the country. These individuals represent over 28,000 companies, including many of the state's and country's largest corporations, and small businesses with as few as two employees.
The summary (overall) rating for this Blue Cross and Blue Shield of Alabama plan is 2.5 out of 5 based on reviews from 21532 user ratings from the previous year. For more information about the review process, visit http://cms.gov.