Florida Blue Medicare offers two stand-alone Medicare Part D prescription drug plans (PDPs) – Premier Rx and Complete Rx. Our PDP plans cover:
Three Ways to Get Medicare Part D Coverage
Add Part D coverage to your Original Medicare Part A and B coverage with a stand-alone Medicare Prescription Drug Plan, called a PDP.
Choose the convenience of a Medicare Advantage Prescription Drug Plan (MAPD) that includes both medical and prescription drug benefits.
Select both a Medicare Supplement Plan and a Medicare Prescription Drug Plan to add to your Original Medicare Part A and B coverage.
Costs for Medicare Prescription Drug Plan Coverage
What Does a Medicare Part D Plan Cost?
Like Original Medicare, Medicare Prescription Drug plans share the cost of care through deductibles, co-payments (copays) and co-insurance. Your actual PDP costs will vary depending on the plan chosen, prescription drugs you use, whether the drugs you use are on your plan's formulary, and whether you go to an in-network pharmacy.
Different Types of Costs for a Medicare PDP:
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Deductible - The amount you pay before Florida Blue Medicare begins to pay its share of the cost.
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Copay - A flat dollar amount (for example, $10) you pay each time you fill a drug.
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Coinsurance - A percentage (for example, 10%) you pay for your prescription drugs.
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Premium - A fixed, monthly amount you pay for your PDP coverage.
2021 Medicare Part D Stages
When total spend reaches $4,130 Enter Coverage Gap
DEDUCTIBLE STAGE
Patient Pays
* varies by plan
* Covered drugs and costs vary from plan to plan
INITIAL COVERAGE
Patient Pays$4,130
Copay/Coinsurance varies by plan
COVERAGE GAP
Patient Pays
25% Brands
25% Generics
CATASTROPHIC COVERAGE
Patient Pays
-5% Brands
-5% Generics
When total spend reaches $4,130 Enter Coverage Gap
When out of pocket reaches $6,550 Exit Coverage Gap
Overview of Florida Blue Medicare Prescription Drug Plans
| Features | Premier | Complete |
|---|---|---|
| Formulary Tiers Covered | Formulary Tiers 1-5 | Formulary Tiers 1-5 |
| Annual Deductible | $405 (Tiers 3-5) | $0 |
| Initial Coverage Stage | $4,130 | $4,130 |
| Catastrophic Stage | $6,550 | $6,550 |
| Nationwide pharmacy network | ||
| $0 select immunizations and vaccinations | ||
| At-home delivery service |
Part D Formulary
What is a formulary?
A formulary is the list of drugs, from brand-name to generic, that are covered by a Medicare Prescription Drug Plan. Covered drugs and costs vary from plan to plan.
Many plans have a tiered formulary, where drugs are divided into groups
called "tiers" based on their cost.
In general, the lower the formulary tier, the lower the cost to you.
Generic drugs typically fall between Tiers 1 and 2.
Part D Formulary Tiers:
Tier 5 (Specialty)$ $ $ $ $
Tier 4 (Non-Preferred)$ $ $ $
Tier 3 (Preferred Brand)$ $ $
Tier 2 (Generics)$ $
Tier 1 (Preferred Generics)$
Have questions or want to know more about Prescription Drug (Part D) plans? Send us your information and one of our agents will reach out to help!
We're always happy to help
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Reach out to us for help or for any questions you have about your Part D insurance plan needs.
Call us at: 1-888-902-5708 TTY 1-800-955-8770
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