Understanding BCBS MedicareRx Coverage and Costs

BCBS MedicareRx offers a range of coverage options for Medicare beneficiaries, including a standard plan and a high-deductible plan.

The standard plan has a deductible of $435 and a maximum out-of-pocket (MOOP) of $7,050.

With BCBS MedicareRx, you'll pay a monthly premium for your prescription coverage, which varies depending on your age and the plan you choose.

You can expect to pay around $30 to $100 per month for the standard plan, depending on your age and location.

Medicare has neither reviewed nor endorsed the information on this website, which was developed by the Blue Cross and Blue Shield Association to help consumers understand certain aspects about Medicare.

To find out about premiums and terms for BCBS MedicareRx plans, how to apply for coverage, and for more information, reach out to your local BCBS company.

BCBS MedicareRx plans have 3 stages of drug coverage: deductible stage, initial coverage stage, and catastrophic coverage stage. In the deductible stage, you pay all out-of-pocket costs until you reach the full deductible, which is $590 in 2025. Some plans don't have a deductible.

In the initial coverage stage, you pay 25% of the cost as coinsurance for your generic and brand-name drugs until your out-of-pocket spending on covered Part D drugs reaches $2,000 in 2025. Then, you'll automatically get catastrophic coverage.

Here's a breakdown of the 3 stages of BCBS MedicareRx drug coverage:

To be eligible for Medicare, you must be a U.S. citizen or a permanent resident who has lived in the U.S. for at least five years.

The Medicare program can be contacted at 1.800.MEDICARE (TTY users should call 1.877.486.2048) or visited at www.medicare.gov for more information about Medicare and a complete list of plans available in your area.

Medicare has neither reviewed nor endorsed the information provided on this website.

Medicare Advantage Plans offer comprehensive coverage for Medicare Parts A and B and include coverage for Prescription Drugs (Part D).

Blue Shield offers various types of Medicare Advantage Prescription Drug Plans (MAPD) in California, including HMO, HMO D-SNP, and PPO plans.

These plans are available in different counties across California, so it's essential to check the specific plans and benefits offered in your area.

Blue Shield 65 Plus (HMO) Group Plan Formulary is an example of a Medicare Advantage Prescription Drug Plan formulary, which is a list of covered drugs.

Your Medicare Part D drug list is divided into coverage tiers, showing brand drugs and generics. To check coverage for any drug you're taking, visit myprime.com/boeing.

Medicare drug plans have three stages: deductible, initial coverage, and catastrophic coverage. The deductible stage has a maximum of $590 in 2025, and some plans don't have a deductible at all.

In the initial coverage stage, you pay 25% of the cost as coinsurance for your generic and brand-name drugs until your out-of-pocket spending reaches $2,000 in 2025. After that, you'll automatically get catastrophic coverage.

If your plan doesn't cover a specific drug, you can ask Blue Shield of California to make an exception to the rules that govern coverage. To do this, visit the Coverage decisions and exceptions page.

The Blue Shield Pharmacy and Therapeutics (P&T) Committee develops and updates the formulary regularly to ensure it meets all Medicare requirements for included and excluded drugs. The committee includes physicians and clinical pharmacists from the provider and pharmacy networks.

Here's a breakdown of the Medicare drug coverage stages:

You'll notice that Medicare drug coverage has three distinct stages, each with its own rules and requirements.

The deductible stage is the first stage, where you pay all out-of-pocket costs until you reach the full deductible, which in 2025 is $590. Some Medicare drug plans don't have a deductible at all.

Once you've reached your deductible, you'll enter the initial coverage stage, where you'll pay 25% of the cost as coinsurance for your generic and brand-name drugs. This stage continues until your out-of-pocket spending on covered Part D drugs reaches $2,000 in 2025.

After that, you'll automatically get "catastrophic coverage", which means you won't have to pay out-of-pocket for covered Part D drugs for the rest of the calendar year.

Here are the three stages of Medicare drug coverage in a nutshell:

Your Medicare Part D drug list is divided into coverage tiers, showing brand drugs and generics. You can check coverage for any drug you're taking by visiting myprime.com/boeing.

If your Medicare plan has a deductible, you'll pay all out-of-pocket costs until you reach the full deductible, which can't be more than $590 in 2025. Some Medicare drug plans don't have a deductible at all.

There are three stages of Medicare drug coverage: the deductible stage, the initial coverage stage, and the catastrophic coverage stage. Here's a brief overview of each stage:

If a drug is not covered by your Part D plan, you can still get coverage for it by looking at the Supplemental Drug List. You can view this list on myprime.com/boeing.