Prescription Blue Option A Prescription Plan for Michigan Medicare Beneficiaries
| Overall Plan Rating: |  |
|---|---|
| Monthly Premium: | $54.30 |
| Pharmacy Co-Pay: | $125.00 |
| Coverage Limit (ICL): | $2,970.00 |
| Pharmacy Mail Order: | Yes |
| Gap Coverage: | No Gap Coverage |
| Low Income Subsidy: | No |
| Medicare Formulary: | 3757 |
| PDP ID No: | S5584-001 |
| Plan Year: | 2013 |
| Approved by CMS for: | MI Residents |
| Rx Plan Type: | Regional |
| Est. Regional Members: | 7768 |
2018 Medicare Prescription Medication Plan Overview
Prescription Blue Option A (PDP) is an approved Medicare Prescription Drug Plan (Part D) for Michigan seniors.
The annual premium is $651.60 ($54.30 monthly), and it carries a $125.00 deductible on all prescribed medications. For 2013, the maximum Part D deductible is $325. It goes up a little each year. It went up $5 from last year.
The Blue Cross Blue Shield of Michigan formulary ID for this plan is 00012161, and it features 3757 FDA approved medications.
For all Michigan 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 Prescription Blue Option A:
- WellCare Classic at $25.70 per month for Michigan Seniors
- First Health Part D Premier Plus at $91.20 per month for Michigan Seniors
- AARP MedicareRx Preferred at $38.20 per month for Michigan Seniors
Prescription Blue Option A 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. This plan has a deductible that you must pay before ICP cost-sharing ICP begins.
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 Prescription Blue Option A (PDP) plan in Michigan is tiered as follows:
| Tier | Co-Pay Amount | Medications in Tier |
|---|---|---|
| 1 | $4.00 | 1624 Preferred Generics |
| 2 | $45.00 | 443 Non-Preferred Generics |
| 3 | $85.00 | 764 Preferred Brands |
| 4 | 25% | 595 Non-Preferred Brands |
| 5 | 25% | 331 Specialty Medications |
The Initial Coverage Limit (ICL) is $2,970.00. This prescription plan does not qualify for the $0 LIS premium.
Prescription Blue Option A (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 Prescription Blue Option A (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 Prescription Blue Option A policy is 7,768. In region 13 (your region) there are approximately 7,768 people with this policy (based on 2011 CMS statistics).
More Information About Blue Cross Blue Shield of Michigan
The Michigan Blues have the largest patient-centered medical home program in the nation — with 2,500 physicians at 770 practices across the state. The Blues PCMH program is helping to lower unnecessary use of health care services that contribute to higher health care costs for everyone. Blue Cross Blue Shield of Michigan was founded in 1939 and employs approximately 7,000 people. It has 4.3 million members in Michigan and 1 million outside the state.
The summary (overall) rating for this Blue Cross Blue Shield of Michigan plan is 3.0 out of 5 based on reviews from 7768 user ratings from the previous year. For more information about the review process, visit http://cms.gov.