Open enrollment for 2010 Medicare Part D programs is now closed. Only those turning 65 or people who qualify for a special election period can still enroll for 2010.  

2010 Plan Benefit Outline

Benefits Description
Your plan coverage will change as you incur more costs. There are three stages of coverage as mandated by Medicare: Initial, Gap and Catastrophic. All Prescription Drug Plans are required to follow this pattern of coverage.

Initial Coverage
When your coverage begins, you must meet a $75 deductible. After you meet your deductible you will pay either a low, fixed copayment or a coinsurance percentage for each prescription and RxBLUE will cover the difference until your TOTAL costs (the combined amount both you and Blue Cross pays) reach $2,830.

Your Initial Coverage Costs
The amount you pay for each drug will depend on the drug type or tier.

Tier	You Pay	Type of Drug
Tier 1	$5	Generic
Tier 2	$30	Preferred Brand
Tier 3	$70	Non-Preferred Brand
Tier 4	31% Coinsurance	Specialty Drugs

Gap Coverage
Once TOTAL costs reach $2,830 you will pay 100% of your drug costs. You will continue to pay 100% of costs until your OUT-OF-POCKET costs (the total of the amounts you have paid) reach $4,550.

Please always continue to use your member ID card to receive the benefit of our discounted rates.

Catastrophic Coverage
When you reach $4,550 OUT-OF-POCKET, you will pay the greater of 5% coinsurance or $2.50 for generics and $6.30 for all other drugs. 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

2010 Premium Information
The RxBLUE (PDP) premium for 2010 is $51.50 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.

Learn more about RxBLUE 2010 Benefits
To find out if RxBLUE (PDP) is right for you, request more information or view the documents below.

• Product Brochure
  Explanation of plan basics and how RxBLUE (PDP) is right for you 
• Summary of Benefits
  Full description of benefits, limitations, out-of-network coverage and protections
• Evidence of Coverage
  Plan details and member rights for 2010
• Pharmacy Directory
  A full list of our participating pharmacies 
• Drug Formulary
  A list of all Medicare-approved drugs covered by RxBLUE (PDP)
• Prior Authorization Criteria
  Drugs requiring prior approval before they can be filled
• Quantity Limit Requirements
  Drugs with restrictions on fill amounts
• Step Therapy Criteria
  Drugs requiring the use of an alternative (typically generic) medication first

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

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Pending CMS Approval