BlueRx Complete Prescription Plan for West Virginia Medicare Beneficiaries
| Overall Plan Rating: |  |
|---|---|
| Monthly Premium: | $113.20 |
| Pharmacy Co-Pay: | $0.00 |
| Coverage Limit (ICL): | $2,970.00 |
| Pharmacy Mail Order: | Yes |
| Gap Coverage: | Many Generics |
| Low Income Subsidy: | No |
| Medicare Formulary: | 4948 |
| PDP ID No: | S5593-003 |
| Plan Year: | 2013 |
| Approved by CMS for: | WV Residents |
| Rx Plan Type: | Regional |
| Est. Regional Members: | 15990 |
2018 Medicare Prescription Medication Plan Overview
BlueRx Complete (PDP) is an approved Medicare Prescription Drug Plan (Part D) for West Virginia seniors.
The annual premium is $1,358.40 ($113.20 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 Highmark Senior Resources Inc. formulary ID for this plan is 00012116, and it features 4948 FDA approved medications.
For all West Virginia 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 Complete:
- SecureRx - Option 3 at $63.80 per month for West Virginia Seniors
- SecureRx - Option 1 at $121.80 per month for West Virginia Seniors
- WellCare Classic at $38.50 per month for West Virginia Seniors
BlueRx Complete 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 Complete (PDP) plan in West Virginia is tiered as follows:
| Tier | Co-Pay Amount | Medications in Tier |
|---|---|---|
| 1 | $7.00 | 1952 Preferred Generics |
| 2 | $40.00 | 705 Non-Preferred Generics |
| 3 | $70.00 | 1973 Preferred Brands |
| 4 | 33% | 318 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 Complete (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 Complete (PDP) plan depends on your specific prescriptions.
The Gap Coverage with this policy: 65% to 100% of formulary generics are covered, but you must pay for Brand Drugs up to $3727.50.
Plan Members
Nationwide, the number of seniors using the BlueRx Complete policy is 15,990. In region 6 (your region) there are approximately 15,990 people with this policy (based on 2011 CMS statistics).
More Information About Highmark Senior Resources Inc.
Highmark was created in 1996 by the consolidation of two Pennsylvania licensees of the Blue Cross and Blue Shield Association — Pennsylvania Blue Shield (now Highmark Blue Shield) and Blue Cross of Western Pennsylvania (now Highmark Blue Cross Blue Shield). We are now one of the largest health insurers in the United States. Highmark is an independent licensee of the Blue Cross Blue Shield Association, an association of Independent Blue Cross and Blue Shield Plans. The Blue Cross and Blue Shield symbols are registered marks of the Blue Cross and Blue Shield Association, an Association of Independent Blue Cross and Blue Shield Plans.
The summary (overall) rating for this Highmark Senior Resources Inc. plan is 4.0 out of 5 based on reviews from 15990 user ratings from the previous year. For more information about the review process, visit http://cms.gov.