Medicare Prescription Drug Plans from BCBSND

Prescription Drug Program iconMedicare Prescription Drug Plan (PDP)
 
 

MedicareBlue Rx
MedicareBlue Rx is our Medicare Prescription Drug Plan, specifically for North Dakota Medicare recipients. You may also hear it referred to as PDP or Medicare Part D.

This is optional coverage, and it can be paired with your current Medicare medical coverage to help pay for prescription drugs. It provides:

  • Protection from unexpected drug costs

  • Coverage of generic drugs, brand-name drugs and specialty drugs

  • More than 59,000 chain and neighborhood drug stores in our pharmacy network (you may pay more if you use a pharmacy outside the network)

Two Plan Options
Standard has a low deductible that you pay first, and then you pay copays and coinsurance for your drugs. Our Premier option does not have a deductible, and coverage with copays and coinsurance starts right away.

 

 

MedicareBlue Rx Standard MedicareBlue Rx Premier

Annual Deductible
This is the amount you pay before coverage begins.

$160

$0

Initial Coverage
This is the amount you pay for a 31-day supply after paying the annual deductible.

Tier 1: Preferred Generic Drugs
Tier 2: Non-Preferred Generic Drugs
Tier 3: Preferred Brand Drugs
Tier 4: Non-Preferred Brand Drugs
 

Cost Sharing

Begins After You
Pay the Deductible

Begins Immediately

Preferred Generic Drugs

$4 copay

$4 copay

Non-Preferred
Generic Drugs

$18 copay

$12 copay

Preferred Brand Drugs

$40 copay

$40 copay

Non-Preferred Brand Drugs

48% coinsurance

48% coinsurance

Coverage Gap
This is the amount you pay for a 31-day supply after your total yearly covered prescription drug costs reach $2,970. Your 'total drug costs' means the total amount you have paid for covered drugs plus what the plan has paid for the calendar year. This does not include the plan premium you pay.

Preferred Generic Drugs

79% coinsurance

$4 copay

Non-Preferred
Generic Drugs

$12 copay

All Other Generics

79% coinsurance

Brand Drugs

Up to 47.5% discount

Up to 47.5% discount

Catastrophic Coverage
The amount you pay for a 31-day supply after you have paid $4,750 in out-of-pocket prescription drug costs. Your 'out-of-pocket costs' means the amount you have paid for covered drugs for the calendar year. This does not include the amount the plan has paid or the plan premium you pay.

Generic Drugs

The greater of $2.65 copay
or 5% coninsurance

The greater of $2.65 copay
or 5% coninsurance

All Other
Covered Drugs

The greater of $6.60 copay
or 5% coninsurance

The greater of $6.60 copay
or 5% coninsurance

 

Is MedicareBlue Rx the right prescription drug plan for you?
Every PDP has its own formulary, a detailed list of drugs available through the plan—so it depends on which drugs you need. MedicareBlue Rx covers a large list of drugs selected for their value and effectiveness, but it does not cover every type of prescription drug. If the MedicareBlue Rx formulary does not match your prescriptions, it might not be the best plan for you.

Click here for the MedicareBlue Rx formulary and more information

 

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MedicareBlue Rx 5 Star rating

The only plan in North Dakota to achieve a perfect 5-star rating

For three years in a row, MedicareBlue Rx has achieved a 5-star rating from the federal Centers for Medicare & Medicaid Services (CMS). It's one of only four plans in the entire country to achieve this distinction, and the only one in the state. This prestigious rating benefits you in the following ways:

  • Enroll or transfer year-round—you can transfer to MedicareBlue Rx at any time of the year (plans that do not have a five-star rating can only be selected during the annual open enrollment period).

  • Receive the best-possible service—the 5-star rating represents "excellent performance" in CMS measurements of a plan's overall quality, including:

    • The quality of its care

    • Access to care

    • Plan responsiveness

    • Beneficiary satisfaction