BlueRx Standard Prescription Plan for Maryland Medicare Beneficiaries
| Overall Plan Rating: |  |
|---|---|
| Monthly Premium: | $105.80 |
| Pharmacy Co-Pay: | $250.00 |
| Coverage Limit (ICL): | $2,970.00 |
| Pharmacy Mail Order: | Yes |
| Gap Coverage: | No Gap Coverage |
| Low Income Subsidy: | No |
| Medicare Formulary: | 4907 |
| PDP ID No: | S5766-002 |
| Plan Year: | 2013 |
| Approved by CMS for: | MD Residents |
| Rx Plan Type: | Regional |
| Est. Regional Members: | 19659 |
2018 Medicare Prescription Medication Plan Overview
BlueRx Standard (PDP) is an approved Medicare Prescription Drug Plan (Part D) for Maryland seniors.
The annual premium is $1,269.60 ($105.80 monthly), and it carries a $250.00 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 Medi-CareFirst BlueCross BlueShield formulary ID for this plan is 00012179, and it features 4907 FDA approved medications.
For all Maryland 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 Standard:
- WellCare Classic at $34.50 per month for Maryland Seniors
- First Health Part D Premier Plus at $92.90 per month for Maryland Seniors
- AARP MedicareRx Preferred at $38.00 per month for Maryland Seniors
BlueRx Standard 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 BlueRx Standard (PDP) plan in Maryland is tiered as follows:
| Tier | Co-Pay Amount | Medications in Tier |
|---|---|---|
| 1 | $8.00 | 2006 Preferred Generics |
| 2 | $30.00 | 250 Non-Preferred Generics |
| 3 | $65.00 | 2257 Preferred Brands |
| 4 | 25% | 394 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 Standard (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 Standard (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 Standard policy is 19,659. In region 5 (your region) there are approximately 19,659 people with this policy (based on 2011 CMS statistics).
More Information About Medi-CareFirst BlueCross BlueShield
Medi-CareFirst BlueCross BlueShield (Medi-CareFirst) is the business name of Group Hospitalization and Medical Services, Inc. and First Care, Inc., which are affiliates of CareFirst, Inc. Medi-CareFirst was created as the underwriting entity for the Medicare Prescription Drug program (commonly known as Part D). Currently Medi-CareFirst offers two Medicare Prescription Drug plans for individuals, BlueRx Standard (PDP) plan and BlueRx Enhanced (PDP) plan. Our Medigap plans are administered through CareFirst, Inc.
CareFirst, Inc. is the not-for-profit, non-stock, parent company of CareFirst of Maryland, Inc., and Group Hospitalization and Medical Services, Inc., affiliates that do business as CareFirst BlueCross BlueShield. CareFirst, Inc. is governed by a Board of Directors and special statutes regulating its business in Maryland, the District of Columbia and Northern Virginia.
The summary (overall) rating for this Medi-CareFirst BlueCross BlueShield plan is 4.0 out of 5 based on reviews from 19659 user ratings from the previous year. For more information about the review process, visit http://cms.gov.