Horizon Medicare Blue Rx Enhanced Prescription Plan for New Jersey Medicare Beneficiaries
| Overall Plan Rating: |  |
|---|---|
| Monthly Premium: | $97.00 |
| 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: | 2984 |
| PDP ID No: | S5993-003 |
| Plan Year: | 2013 |
| Approved by CMS for: | NJ Residents |
| Rx Plan Type: | Regional |
| Est. Regional Members: | 20602 |
2018 Medicare Prescription Medication Plan Overview
Horizon Medicare Blue Rx Enhanced (PDP) is an approved Medicare Prescription Drug Plan (Part D) for New Jersey seniors.
The annual premium is $1,164.00 ($97.00 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 Horizon Blue Cross Blue Shield of New Jersey, Inc formulary ID for this plan is 00012249, and it features 2984 FDA approved medications.
For all New Jersey 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 Horizon Medicare Blue Rx Enhanced:
- WellCare Classic at $36.00 per month for New Jersey Seniors
- AARP MedicareRx Preferred at $39.20 per month for New Jersey Seniors
- Humana Enhanced at $43.40 per month for New Jersey Seniors
Horizon Medicare Blue Rx Enhanced 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 Horizon Medicare Blue Rx Enhanced (PDP) plan in New Jersey is tiered as follows:
| Tier | Co-Pay Amount | Medications in Tier |
|---|---|---|
| 1 | $7.00 | 1908 Preferred Generics |
| 2 | $37.00 | 601 Non-Preferred Generics |
| 3 | $74.00 | 267 Preferred Brands |
| 4 | 33% | 208 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.
Horizon Medicare Blue Rx Enhanced (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 Horizon Medicare Blue Rx Enhanced (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 Horizon Medicare Blue Rx Enhanced policy is 20,602. In region 4 (your region) there are approximately 20,602 people with this policy (based on 2011 CMS statistics).
More Information About Horizon Blue Cross Blue Shield of New Jersey, Inc
Horizon Blue Cross Blue Shield of New Jersey traces its history back to 1932, when Associated Hospitals of Essex County, Inc. began selling multi-hospital, pre-payment plans for $10 a year, which covered 21 days of in-patient care. The company was one of the first health insurance companies in the nation and also one of the first Blue Cross plans.
Today, Horizon BCBSNJ serves more than 3.6 million members. In 2010, the company processed more than 57.6 million claims totaling more than $13 billion for its members. The company has more than 4,800 employees and is headquartered in Newark with offices in Harrison, Wall Township, Mt. Laurel, and West Trenton.
The summary (overall) rating for this Horizon Blue Cross Blue Shield of New Jersey, Inc plan is 3.5 out of 5 based on reviews from 20602 user ratings from the previous year. For more information about the review process, visit http://cms.gov.