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What are the costs and benefits?
Medi-CareFirst offers two Part D plans, Blue Rx Standard (PDP) and Blue Rx Enhanced (PDP). Both plans are approved by Medicare, and offer the same basic benefits:
- The same copayments/coinsurance for your prescription drugs.
- A 90-day supply of maintenance medications for only two copays.
- A 34-day supply for one month.
Additionally, Blue Rx Enhanced (PDP) offers coverage for all Generic drugs while members are in the coverage gap, and does not have an annual deductible. The chart below compares the benefits of Blue Rx Standard (PDP) and Blue Rx Enhanced (PDP).
| Blue Rx Standard (PDP) | Blue Rx Enhanced (PDP) | |
|---|---|---|
| You Pay In-Network* | ||
| Monthly Premium | $74.40** | $120.20** |
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Annual Deductible (amount you must pay out-of-pocket before Medi-CareFirst pays its share) |
$150 | $0 |
Initial Coverage Limit |
For 34-day supply you pay:
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For 34-day supply you pay:
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For 90-day supply of maintenance drugs you pay:
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For 90-day supply of maintenance drugs you pay:
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Coverage Gap (amount you pay until your out-of-pocket expenses reach $4,550) |
For 34-day supply you pay:
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For 34-day supply you pay:
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For 90-day supply of maintenance drugs you pay:
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For 90-day supply of maintenance drugs you pay:
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Catastrophic Coverage (amount you pay after your out-of-pocket expenses reach $4,550) |
You pay whichever is the greater cost:
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* The copays listed above are for In-Network pharmacies. You must use In-Network pharmacies, except under emergency circumstances.
** If you missed your Initial Enrollment Period you will likely pay an additional 1% of the base beneficiary premium for each month that you did not have coverage that was at least as good as the Medicare Prescription Drug Program. You also must continue to pay your Medicare Part B premium, if not otherwise paid for under Medicaid or by another third party.
*** Self-Administered Medical Injectables are covered under Cost-share Tiers 1, 2 and 3.
Additional Features
Both Blue Rx (PDP) plans:
- Accept prescriptions from any doctor, so you may see any doctor you wish.
- Include a large regional network of 1400 pharmacies, as well as a national network of more than 60,000 pharmacies (including retail, home-infusion and long-term care pharmacies).
- Offer a free, optional Medication Management Program to help members with several medical conditions choose drugs that work best together to treat those conditions.
Learn More
Review a complete list of plan benefits:
- Summary of Benefits (PDF)
- Evidence of Coverage - Blue Rx Standard (PDF)
- Evidence of Coverage - Blue Rx Enhanced (PDF)
For more information:
- Visit our Frequently Asked Questions section.
- If you live in Maryland and think you might be eligible for extra help, please call the Senior Prescription Drug Assistance Program (SPDAP) at 1-800-551-5995 (TTY: 1-800-877-5156) from 8 a.m. - 5 p.m. EST, weekdays.
- If you live in Delaware and think you might be eligible for extra help, please call the Delaware Prescription Drug Assistance or Delaware Chronic Renal Disease programs at 1-800-996-9969 (TTY: 800-232-5460). Select option 2, then option 1.
Plan Resources
Additional Information
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Sign up when you are eligible or you may have to pay a penalty.
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If you have limited resources and income, you may be eligible for extra help.
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Medi-CareFirst offers a free Medication Management Program to all Blue Rx (PDP) plan members.
We administer Maryland's SPDAP program
Find out what it is and if you're eligible.