Understanding your coverage and benefits
Your Blue MedicareRx (PDP) plan provides affordable access to covered prescription drugs from our extensive pharmacy network. The following information may help you better understand the basics of your coverage. Additional information is available in the Evidence of Coverage.
Covered Drugs/Formulary
Your Blue MedicareRx comprehensive formulary lists the thousands of drugs we cover. Refer to the formulary to ensure any new drug treatment prescribed by your doctor is covered. You can also use our Drug Pricing Tool to help you search for covered drugs and determine your out-of-pocket costs.
Learn morePlan & Drug Costs
The total annual cost of your coverage includes: the deductible you pay 1 , your monthly premium payments (x12), and the amount you pay for your medications. Refer to your Evidence of Coverage for details about your plan costs.
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Pharmacy Networks
To access your prescription drug benefits, you must use our network pharmacies to fill your prescriptions. Use the Pharmacy Locator to find a network pharmacy near you.
Retail Pharmacies
Blue MedicareRx (PDP) offers an extensive network with more than 63,000 pharmacies nationwide, including 20,000 preferred retail pharmacies that offer lower copays and coinsurance.
Learn moreMail Service Pharmacy
Take advantage of savings up to 66% on Tier 1 drugs by having your medications delivered by mail with our CVS Caremark Mail Service Pharmacy™ benefit. 2
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Medicare Part D Coverage Stages & the Coverage Gap
Medicare Part D coverage includes four stages: Deductible, Initial Coverage Stage, Coverage Gap (or Donut Hole) and Catastrophic Coverage. It’s important to understand each stage and how they may affect what you pay for your prescription drugs.
Learn moreCoverage Determination
Our goal is to provide you with a variety of prescription medications that are safe, effective and affordable. However, if you discover that a drug prescribed for you is not covered, you may request a coverage determination.
Learn more1 Blue MedicareRx Value Plus members pay $0 deductible on Tier 1 and 2 drugs. Premier members pay $0 deductible on all covered drugs. Back
2 Percent savings based on copays on 90-day supplies of Tier 1 drugs obtained through CVS Caremark Mail Service Pharmacy vs. copays on 90-day supplies of Tier 1 drugs obtained through a Blue MedicareRx Preferred Network Pharmacy. Call Customer Care for specific pricing of your medications. Typically, you should expect to receive your prescription within 10 calendar days from the time the mail service pharmacy receives your order. Back