RxBLUE Plus PDP covers an open formulary of all Medicare Part D-approved prescription drugs and is accepted at a wide selection of pharmacies across Louisiana.
RxBLUE Plus PDP benefits go into effect January 1, 2012.
You have a $0 deductible and you pay $3 for generic drugs. A list of generics can be found in the
RxBLUE Plus PDP 2012 Formulary Guide.
If you choose a brand-name drug, you'll pay $35 for Preferred Brands and $70 for Non-Preferred Brands. For Specialty drugs, you'll pay 33 percent coinsurance,
which means you pay 33 percent of the cost of the drug and Blue Cross pays 67 percent.
Once your costs and Blue Cross costs combined reach $2,930, you'll receive discounts on brand-name drugs
and pay $3 or less for all generic drugs until your out-of-pocket costs reach $4,700. This is often referred
to as the "coverage gap." But each time you use your member ID card at a network pharmacy, you'll have
access to Blue Cross discounts at the point of purchase.
RxBLUE Plus PDP protects you financially from catastrophic prescription costs in the event of a serious medical
condition. Once your out-of-pocket costs reach $4,700, you pay only 5 percent coinsurance or $2.60 for
a generic drug and $6.50 for all other drugs – whichever is greater. Blue Cross pays the rest.
This level of coverage lasts until the end of your plan year.
Please note: If you believe you have already qualified for low income subsidy and believe you are paying an incorrect copayment amount, Medicare has established a process that will allow you to provide evidence of your proper copayment level. Learn more
The RxBLUE Plus PDP premium for 2012 is $98.20 per month. Lower premiums and coinsurance payments are available for those who have qualified for Extra Help.
You must continue to pay your Medicare Part B premium if it is not otherwise paid for under Medicaid or another third-party.
Blue Cross and Blue Shield of Louisiana is incorporated as Louisiana Health Service & Indemnity Company, a Medicare-approved Part D sponsor.
The benefit information provided herein is a brief summary, not a comprehensive description of benefits. For more information contact the plan.
Benefits, formulary, pharmacy network, premium and/or co-payments/co-insurance may change on January 1, 2013.
You must continue to pay your Medicare Part B premium.
You may be able to get Extra Help to pay for your prescription drug premiums and costs. To see if you qualify for extra help, call:
People with limited incomes may qualify for Extra Help to pay for their prescription drug costs. If you qualify, Medicare could pay for up to seventy-five (75) percent or more of your drug costs including monthly prescription drug premiums, annual deductibles, and co-insurance. Additionally, those who qualify will not be subject to the coverage gap or a late enrollment penalty. Many people are eligible for these savings and don't even know it. For more information about this Extra Help, contact your local Social Security office or call 1-800-MEDICARE (1-800-633-4227), 24 hours per day, 7 days per week. TTY users should call 1-877-486-2048. Limitations, copayments and restrictions may apply.
You must use network pharmacies to access your prescription drug benefit, except under non-routine circumstances.
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