BlueMedicare Complete RX (PDP)

2021 Summary of Benefits

Summary of Benefits - Statewide (PDF)


2021 Evidence of Coverage
Evidence of Coverage - Statewide (PDF)


2021 Annual Notice of Change

Annual Notice of Change - Statewide (PDF)


2021 Comprehensive Formulary

Comprehensive Formulary - Statewide (PDF)


2021 Other Information and Documents

Enrollment Form (PDF)

Service Area Map (PDF)

Medicare Star Rating (PDF)

Low-Income Subsidy - Medicare Extra Help Program (PDF)

Prescription Drug Transition Policy (PDF)


FBM FORM BMCRX 003 NF 102020