I need a prescription drug plan.

What are the costs and benefits?

The following information is for the 2008 plan year. For information on the 2009 plan year, click here.

Medi-CareFirst offers two Part D plans, Blue Rx Standard and Blue Rx Enhanced. Both plans are approved by Medicare, and offer the same basic benefits:

  • No deductible
  • The same copayments/coinsurance for your prescription drugs.

Additionally, Blue Rx Enhanced offers coverage for Generic drugs while members are in the coverage gap. The chart below compares the benefits of Blue Rx Standard and Blue Rx Enhanced.

Your Blue Rx Plan Options
  Blue Rx Standard Plan Blue Rx Enhanced Plan
 

You Pay In-Network*

Monthly Premium

$42.10**

$66.20**

Annual Deductible (amount you must pay out-of-pocket before Medi-CareFirst pays its share)

$0

$0

Initial Coverage Limit  (amount you and your plan pay In-Network for the first $2,510 in total drug costs)

 

For 34-day supply you pay:

  • $8 for Generic (Tier 1)
  • $25 for Preferred Brand-Name (Tier 2)
  • $69 for Non-Preferred Brand-Name (Tier 3)
  • 25% for Non-Self Administered Medical Injectables (Tier 4)***

For 34-day supply you pay:

  • Same as for Blue Rx Standard Plan

For 90-day supply you pay:

  • $16 for Generic (Tier 1)
  • $50 for Preferred Brand-Name (Tier 2)
  • $138 for Non-Preferred Brand-Name (Tier 3)
  • 25% for Non-Self Administered Medical Injectables (Tier 4)***

For 90-day supply you pay:

  • Same as for Blue Rx Standard Plan

Coverage Gap (amount you pay until your out-of-pocket expenses reach $4,050)

For 34-day supply you pay:

  • Generic: 100%
  • Brand: 100%

For 34-day supply you pay:

  • Generics: $8
  • Brand: 100%

For 90-day supply you pay:

  • Generic: 100%
  • Brand: 100%

For 90-day supply you pay:

  • Generics: $16
  • Brand: 100%
Catastrophic Coverage (amount you pay after your out-of-pocket expenses reach $4,050)

You pay whichever is the greater cost:

  • $2.25 for Generic or Brand-Name Drugs treated as Generics
  • $5.60 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% 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 Tiers 2 and 3.

Additional Features

Both Blue Rx plans:

  • Accept prescriptions from any doctor, so you may see any doctor you wish
  • Include a large regional network of 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

For more information:

  • Visit our Frequently Asked Questions section
  • If you live in Maryland, please call the Maryland Senior Prescription Drug Assistance Program (SPDAP). Call 1-800-215-8038 (9 a.m. - 5 p.m. EST, weekdays).
  • If you live in Delaware, please call the Delaware Prescription Drug Assistance or Delaware Chronic Renal Disease programs. Call 1-800-996-9969, Extension 2.
Additional Information
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