Florida Blue Medicare Prescription Drug Plans

Until you meet your plan deductible, you will pay the full price for your covered prescription drugs. Once you have met the deductible, your plan will begin to cover the cost of your drugs.

After you meet your deductible, your plan will help pay for your covered prescription drugs. Your plan will pay some of the cost, and you will pay a copayment or coinsurance, until you reach your initial coverage limit. In the coverage gap, you may pay more for your drugs than you did in the initial coverage stage. When you’re in the coverage gap, you’ll usually pay 25 percent of the plan’s costs for brand name drugs and 37 percent of the plan’s costs for generic drugs You stay in the coverage gap until your total out-of-pocket drug spending reaches $5,100. If you get any discounts on brand-name drugs, we count it as though you paid the full price. This helps you move through the coverage gap a little faster.

After you reach out-of-pocket costs for covered drugs (this amount is just the amount you have paid, not the total drug costs that you and your plan have paid), you reach catastrophic coverage. During this period, you pay significantly lower copays or coinsurance for your covered drugs for the remainder of the year.