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BlueRx Overview Duplicate 1

BlueRx Plans Include:

  • 63,000 Pharmacies Nationwide >
  • Mail-Order Pharmacy Service >
  • Prescriptions as Low as $0 >
  • $0 Deductible Option >
  • Standard Cost-Sharing Pharmacies
  • Save 33% on prescription drug costs
  • 3 plan options
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63,000 Pharmacies Nationwide

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63,000 Pharmacies Nationwide

 

BlueRx Essential: STANDARD Pharmacy Network. Standard cost-sharing is available at over 900 retail pharmacies including CVS, Publix, Walgreens, Walmart and hundreds of other local independent neighborhood pharmacies!

BlueRx ENHANCED and BlueRx ENHANCED PLUS: PREFERRED Pharmacy Network. Preferred cost-sharing is available at retail pharmacies that now include Costco, Kroger, Publix, Walgreens, Walmart, Winn-Dixie, Sam's Club and HUNDREDS of local independent neighborhood pharmacies. At Preferred pharmacies, you can get a 90-day supply of routine medication but pay only the copay for a 60-day supply.

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Mail-Order Pharmacy Service

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Mail-Order Pharmacy Service

 

Home Delivery Pharmacy Service is also available. Get your routine medication without leaving your home! When you use our Home Delivery Pharmacy Service you can get a 90-day supply by mail but pay only the copay for a 60-day supply. That’s one month at no cost to you…along with free standard shipping!

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Prescriptions as Low as $0

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Prescriptions as Low as $0

 

What you pay — up to a Total Rx annual spend of $5,030 (the Initial Coverage Limit in 2024)

DEDUCTIBLE: Your Rx spending before plan benefits begin

COPAY: What you pay for prescriptions after reaching the deductible

Tier 1 – BlueRx ESSENTIAL (STANDARD Cost-Sharing Pharmacy): Preferred Generic $0 after deductible

Click here for ways to ensure you are paying the least amount for your prescriptions with Rx Savings Solutions.

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$0 Deductible Option

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$0 Deductible Option

 

DEDUCTIBLE: Your Rx spending before plan benefits begin

BlueRx ENHANCED PLUS: $0 deductible; $153.70 monthly plan premium

Choose from three options to fit your needs:

 

BlueRx Essential

  • Lowest monthly premium
  • $545 deductible
  • Copays as low as $0
  • Standard Cost-Sharing Pharmacies

BlueRx Enhanced

  • $545 deductible
  • Copays as low as $2
  • More covered brand-name drugs
  • Preferred Cost-Sharing Pharmacies

BlueRx Enhanced Plus

  • $0 deductible
  • Copays as low as $2
  • More covered brand-name drugs
  • Preferred Cost-Sharing Pharmacies


 

Use routine maintenance drugs?

No matter which BlueRx plan you choose, you'll save time and money on a 90-day supply with our convenient Mail-Order Home Delivery Pharmacy Service. With a 90-day fill, you get a 3-month supply for the cost of 2 months — and enjoy FREE shipping right to your door.



 
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BlueRx

Essential
(PDP)

$72.00 per month

View LIS Pricing >

Based on your income, you may qualify for financial help from Medicare to lower your monthly premium.* If you qualify, you will also have no drug coverage gap and lower out-of-pocket costs. If you aren't receiving extra help, the Alabama State Health Insurance Assistance Program (SHIP) provides education and counseling on low-income assistance programs for Medicare.

1-800-AGE-LINE (1-800-243-5463) TTY 1-800-548-2547

Medicare beneficiaries can qualify for Extra Help paying for their monthly premiums, annual deductibles, and co-payments related to Medicare prescription drug coverage. https://www.ssa.gov/benefits/medicare/prescriptionhelp

Plan Name No LIS 100%
BlueRx Essential (PDP)
72.00
30.60

You may be able to get Extra Help to pay for your prescription drug premiums and costs. To see if you qualify for getting Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/7 days a week; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call 1-800-325-0778; or your State Medicaid Office.

*You must continue to pay your Medicare Part B premium if not otherwise paid for under Medicaid or by another third party.

BlueRx

Enhanced
(PDP)

$119.50 per month

View LIS Pricing >

Based on your income, you may qualify for financial help from Medicare to lower your monthly premium.* If you qualify, you will also have no drug coverage gap and lower out-of-pocket costs. If you aren't receiving extra help, the Alabama State Health Insurance Assistance Program (SHIP) provides education and counseling on low-income assistance programs for Medicare.

1-800-AGE-LINE (1-800-243-5463) TTY 1-800-548-2547

Medicare beneficiaries can qualify for Extra Help paying for their monthly premiums, annual deductibles, and co-payments related to Medicare prescription drug coverage. https://www.ssa.gov/benefits/medicare/prescriptionhelp

Plan Name No LIS 100%
BlueRx Enhanced (PDP)
119.50
78.10

You may be able to get Extra Help to pay for your prescription drug premiums and costs. To see if you qualify for getting Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/7 days a week; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call 1-800-325-0778; or your State Medicaid Office.

*You must continue to pay your Medicare Part B premium if not otherwise paid for under Medicaid or by another third party.

BlueRx

Enhanced Plus (PDP)

$153.70 per month

View LIS Pricing >

Based on your income, you may qualify for financial help from Medicare to lower your monthly premium.* If you qualify, you will also have no drug coverage gap and lower out-of-pocket costs. If you aren't receiving extra help, the Alabama State Health Insurance Assistance Program (SHIP) provides education and counseling on low-income assistance programs for Medicare.

1-800-AGE-LINE (1-800-243-5463) TTY 1-800-548-2547

Medicare beneficiaries can qualify for Extra Help paying for their monthly premiums, annual deductibles, and co-payments related to Medicare prescription drug coverage. https://www.ssa.gov/benefits/medicare/prescriptionhelp

Plan Name No LIS 100%
BlueRx Enhanced Plus (PDP)
153.70
112.30

You may be able to get Extra Help to pay for your prescription drug premiums and costs. To see if you qualify for getting Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/7 days a week; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call 1-800-325-0778; or your State Medicaid Office.

*You must continue to pay your Medicare Part B premium if not otherwise paid for under Medicaid or by another third party.

Deductible
The amount you pay for eligible health services in a year before your insurance policy begins to share costs. If your deductible is $1,500, for example, you’ll pay for eligible costs for up to $1,500 before your policy helps pay for covered services.
$545 $545 $0
PREFERRED Cost-Sharing Pharmacy Copays
A set fee you pay for a healthcare service, such as a visit to a doctor or hospital, or for a prescribed medication.
/ Coinsurance
The portion of the cost for healthcare that you will pay after you’ve met your deductible. For example, if you’ve met your deductible and your coinsurance is 20% and you receive a bill for $100, you’ll pay $20 and your insurance will pay the rest.
Tier 1 - Preferred Generic N/A $2 $2
Tier 2 - Generic N/A $8 $10
Tier 3 - Preferred Brand N/A $40 $40
Tier 4 - Non-Preferred Drug N/A 29% 29%
Tier 5 - Specialty Tier N/A 25% 33%
Select Insulins (Tiers 3 & 4) N/A $35 $35
STANDARD Cost-Sharing Pharmacy Copays
A set fee you pay for a healthcare service, such as a visit to a doctor or hospital, or for a prescribed medication.
/ Coinsurance
The portion of the cost for healthcare that you will pay after you’ve met your deductible. For example, if you’ve met your deductible and your coinsurance is 20% and you receive a bill for $100, you’ll pay $20 and your insurance will pay the rest.
Tier 1 - Preferred Generic $0 $9 $9
Tier 2 - Generic $14 $15 $17
Tier 3 - Preferred Brand $47 $47 $47
Tier 4 - Non-Preferred Drug 46% 34% 34%
Tier 5 - Specialty Tier 25% 25% 33%
Select Insulins (Tiers 3 & 4) $35 $35 $35
Coverage Gap Phase Once the TOTAL prescription annual spending exceeds $5,030 and YOUR spending is below $8,000 you pay 25% of generic drug costs and 25% of brand-name drug costs. Once the TOTAL prescription annual spending exceeds $5,030 and YOUR spending is below $8,000 you pay 25% of generic drug costs and 25% of brand-name drug costs. Once the TOTAL prescription annual spending exceeds $5,030 and YOUR spending is below $8,000 you pay 25% of generic drug costs and 25% of brand-name drug costs.
Catastrophic Coverage Phase Once YOUR out-of-pocket spending on prescriptions reaches $8,000 you pay nothing. Once YOUR out-of-pocket spending on prescriptions reaches $8,000 you pay nothing. Once YOUR out-of-pocket spending on prescriptions reaches $8,000 you pay nothing.
 


Based on your income, you may qualify for financial help from Medicare to lower your monthly premium.* If you qualify, you will also have no drug coverage gap and lower out-of-pocket costs. If you aren't receiving extra help, the Alabama State Health Insurance Assistance Program (SHIP) provides education and counseling on low-income assistance programs for Medicare.  

1-800-AGE-LINE (1-800-243-5463) TTY 1-800-548-2547

 

 






















 
Plan Name No LIS 100%
BlueRx Essential (PDP)
50.20
17.50

 


You may be able to get Extra Help to pay for your prescription drug premiums and costs. To see if you qualify for getting Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/7 days a week; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call 1-800-325-0778; or your State Medicaid Office.

 

*You must continue to pay your Medicare Part B premium if not otherwise paid for under Medicaid or by another third party.

 

 

Insulin Disclaimer

Important Message About What You Pay for Vaccines - Our plan covers most Part D vaccines at no cost to you, even if you haven't paid your deductible. Call Member Services for more information. 
 
Important Message About What You Pay for Insulin - You won’t pay more than $35 for a one-month supply of each insulin product covered by our plan, no matter what cost-sharing tier it's on.

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