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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).


Your Blue Rx (PDP) Plan Options
  Blue Rx Standard (PDP) Blue Rx Enhanced (PDP)
  You Pay In-Network*
Monthly Premium $74.40** $120.20**
Annual Deductible
(amount you must pay out-of-pocket before Medi-CareFirst pays its share) 		$150 $0

Initial Coverage Limit
(amount you and your plan pay In-Network for the first $2,830 in total drug costs)

For 34-day supply you pay:

  • $10 for Generic (Tier 1)
  • $30 for Preferred Brand-Name (Tier 2)
  • $70 for Non-Preferred Brand-Name (Tier 3)
  • 25% for Non-Self Injectables (Tier 4)***

For 34-day supply you pay:

  • Same as for Blue Rx Standard (PDP)

For 90-day supply of maintenance drugs you pay:

  • $20 for Generic (Tier 1)
  • $60 for Preferred Brand-Name (Tier 2)
  • $140 for Non-Preferred Brand-Name (Tier 3)
  • 25% for Non-Self Injectables (Tier 4)***

For 90-day supply of maintenance drugs you pay:

  • Same as for Blue Rx Standard (PDP)
Coverage Gap
(amount you pay until your out-of-pocket expenses reach $4,550)

For 34-day supply you pay:

  • Generic: 100%
  • Brand: 100%

For 34-day supply you pay:

  • Generics: $10
  • Brand: 100%

For 90-day supply of maintenance drugs you pay:

  • Generic: 100%
  • Brand: 100%

For 90-day supply of maintenance drugs you pay:

  • Generics: $20
  • Brand: 100%
Catastrophic Coverage
(amount you pay after your out-of-pocket expenses reach $4,550)

You pay whichever is the greater cost:

  • $2.50 for Generic or Brand-Name Drugs treated as Generics
  • $6.30 for all other covered drugs OR
    5% of the Drug's Cost (Generic or Brand)
NOTES:

* 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:


For more information:


Next, see if your drugs are covered.

Plan Resources

Additional Information

  • Sign up when you are eligible or you may have to pay a penalty.
  • If you have limited resources and income, you may be eligible for extra help.
  • Medi-CareFirst offers a free Medication Management Program to all Blue Rx (PDP) plan members.
Senior Prescription Drug Assistance Program

We administer Maryland's SPDAP program

Find out what it is and if you're eligible.