Quality Assurance
The RxBLUE Evidence of Coverage (EOC) includes information on RxBLUE’s quality assurance policies and procedures. You can find information regarding drug management programs such as utilization management (prior authorizations, quantity limits, step therapy and generic substitutions) and medication therapy management. Within the EOC, quality assurance policies can be found beginning on page 21 in section 3.

Medication Therapy Management
The RxBLUE Medication Therapy Management program is available at no cost for members who meet specific criteria. Members who have multiple medical conditions, who are taking certain prescription drugs or who have high drug costs may be eligible for the program. More information can be found on page 22 of the EOC or by contacting RxBLUE Customer Service. 

Contract Termination and Member Rights
RxBLUE has a contract with the Centers for Medicare & Medicaid Services (CMS) that may be renewed each year. However, either RxBLUE or CMS can decide to end the contract at any time. If we leave the Medicare program or no longer offer prescription drug coverage in the service area where you live, we will notify you in writing. If either situation occurs, your membership in our Plan will end, and you will have to enroll in another Medicare Prescription Drug Plan or in a Medicare Advantage Plan with prescription drug coverage to continue receiving prescription drug benefits. More information can be found in the RxBLUE Evidence of Coverage (EOC) beginning on page 57.

Blue Cross and Blue Shield of Louisiana has contracted with the Centers for Medicare & Medicaid Services to offer RxBLUE, a Medicare Part D prescription drug plan.

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