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Stand-alone Prescription Drug Plans can help reduce your costs for medications

Medicare Part D Prescription Drug Plans (PDP) help people with Medicare afford prescription drugs since Original Medicare doesn’t cover medications. If you have Original Medicare, you may want a PDP to get coverage for your drugs. Medicare Part D plans are sold by private insurance companies, like Florida Blue. Florida Blue offers two stand-alone Medicare Prescription Drug Plans (Part D).

Premier Rx and Complete Rx cover:

Many generic and brand-name drugs with predictable copayments

An extensive list of plan-covered drugs (formulary)

May include a low-cost mail-order pharmacy service for free home delivery of your medications

A nationwide pharmacy network

Three ways to get Medicare Part D coverage

Add Part D coverage to your Original Medicare Parts A and B coverage with a stand-alone Medicare Prescription Drug Plan (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 Parts A and B coverage.

What does a Medicare Part D plan cost?

Different types of costs for a Medicare Part D plan:

  • Deductible - The amount you pay before Original Medicare begins to pay its share of the cost.
  • Copay - A flat dollar amount (for example, $10) you pay each time you fill a drug.
  • Coinsurance - A percentage (for example, 10%) you pay for your prescription drugs.
  • Premium - A fixed, monthly amount you pay for your PDP coverage.

2024 Medicare Part D stages

DEDUCTIBLE STAGE

patient pays

*varies by plan

*covered drugs and costs vary from plan to plan

INITIAL COVERAGE

patient pays

$5,030 copay/coinsurance varies by plan

when total spend reaches

$5,030

enter Coverage Gap

COVERAGE GAP

patient pays

25% Brands

25% Generic

*varies by plan, some plans may include drug coverage through the gap

when out-of-pocket reaches

$8,000

exit Coverage Gap

CATASTROPHIC COVERAGE

for covered Part D drugs, patient pays

$0

Overview of 2024 Florida Blue Medicare Prescription Drug Plans

Features BlueMedicare Premier Rx (PDP) Blue Medicare Complete Rx (PDP)

Formulary Tiers Covered

Formulary Tiers 1-5

Formulary Tiers 1-5

Annual Deductible

$545

(Tiers 3-5)

$0

Initial Coverage Stage

$5,030

$5,030

Catastrophic Stage

$8,000

$8,000

Nationwide pharmacy network

$0 select immunizations and vaccinations

At-home delivery service

Medicare 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 are on 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) $ $

 

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FBM PRODUCT NF
Last Updated: 10.01.2023
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