Enrollment for 2009 is now closed. Only those turning 65 or people who qualify for a special election period can still enroll for 2009. If you are still eligible, you can enroll in RxBLUE (PDP) easily by mail, phone or internet. Enroll today or call Customer Service for more details.

Benefits Summary

• Low copayments—including $8 for all generics 
• A formulary that includes ALL Medicare Part D-approved prescription drugs 
• A wide selection of pharmacies across Louisiana  
• NO deductible
• Automatic claims filing on your behalf 
• Monthly tracking of your year-to-date prescription drug spending whenever you fill a prescription 
• Protection from catastrophic drug expenses 
• Customer service seven days a week

Plan Outline
The 2009 RxBLUE (PDP) plan is outlined in the chart below.

RxBLUE (PDP) has a tiered payment structure. That means, during your initial coverage, you will pay a low, fixed amount (copayment) or a coinsurance percentage for each drug, depending on the drug type (tier).

Until your total drug costs reach $2,700, you will pay the amounts below, and your planwill cover the difference. 

• Tier 1  $8  Generic
• Tier 2  $32  Preferred Brand
• Tier 3  $73  Non-Preferred Brand
• Tier 4  33%  member coinsurance for Specialty drugs

After your total drug costs reach $2,700, you will pay 100% of your drug costs. Please always continue to use your member ID card to receive the benefit of our discounted rates.

When you reach $4,350 out-of-pocket, you qualify for catastrophic coverage, meaning you pay the greater of 5% coinsurance or $2.40 for generics and $6.00 for all other drugs.

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

Premium Information
The RxBLUE (PDP) premium for 2009 is $45.30 per month. Lower premiums and coinsurance payments are available for those who have qualified for Extra Help. Find out more about qualifying 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.

Learn more about RxBLUE (PDP) 
To find out if RxBLUE (PDP) is right for you, request more information or view the PDF documents below. These PDF documents will help you learn as much as possible about the 2009 RxBLUE (PDP)plan.

• 2009 Product Brochure
  Explanation of plan basics and how RxBLUE (PDP) is right for you 
• 2009 Summary of Benefits
  Full description of benefits, limitations, out-of-network coverage and protections given to you under this plan 
• 2009 Evidence of Coverage
  Plan details and member rights for 2009
• 2009 Pharmacy Directory
  A full list of our participating pharmacies 
• 2009 Drug Formulary
  A list of all Medicare-approved drugs covered by RxBLUE (PDP) 
• 2009 Drug Prior Authorization Criteria
  This is a list of drugs that require prior approval before they can be filled.

Our Organization contracts with the Federal government. RxBLUE (PDP) is a stand-alone prescription drug plan with a Medicare contract.

Benefits, formulary, pharmacy network, premium and co-payments/co-insurance may change on January 1, 2010. Please contact RxBLUE (PDP) for details.

Note: Files in Adobe PDF format require Adobe Acrobat Reader to open. You can download Adobe Acrobat Reader for free by clicking the graphic below.

Pending CMS Approval