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Would you like a Medicare drug plan that offers peace of mind and a low premium? With MedBlue RxSM (PDP), a Medicare prescription drug plan, you save on the drugs you need at more than 64,000 network pharmacies nationwide, and more than 1000 in South Carolina. You can join MedBlue Rx (PDP) if you are a South Carolina resident entitled to Medicare Part A and/or enrolled in Medicare Part B. Eligible individuals enrolled in a Medicare Advantage (MA) private-fee-for-service (PFFS) plan that includes Medicare precription drug coverage or any MA coordinated (HMO or PPO) plan will be automatically disenrolled from the HMO, PPO or PFFS plan if they enroll in a prescription drug plan (PDP). Eligible individuals enrolled in a MA PFFS plan that does not include Medicare prescription drug coverage, a MA Medical Savings Account (MSA) plan or an 1876 Cost plan may enroll in a PDP and will not be automatically disenrolled from the PFFS, MSA or 1876 Cost plan.
The monthly premium for MedBlue Rx (PDP) is $42.80. You must continue to pay your Medicare Part B premium.
BlueCross has formed a network of pharmacies that you must use to receive MedBlue Rx (PDP) plan benefits. In general, you must use network pharmacies to access your prescription drug benefit, except in non-routine circumstances. Quantity limits and restrictions may apply. For an up-to-date list of the pharmacies in our network, see our Pharmacy Directory. You can also search by pharmacy name, state or ZIP code using the Pharmacy Locator. (This link leads to a third party website. That company is solely responsible for the contents and privacy policy on its site.)
MedBlue Rx (PDP) uses a prescription drug list. We may occasionally make changes to the list. You will receive 60 days' notice of the removal or change in the tier placement of any drug on our formulary. For the most current information, see our Comprehensive Formulary (list of covered prescription drugs). To search for a specific drug on this formulary, simply open the formulary and select the Search button in the task bar at the top of the page. Then type the name of the drug in the search box and select Search. Some prescriptions require prior authorization. For a list of these drugs and their authorization forms, please visit our Prior Authorization Criteria drug list. Formulary Change Notice - January Formulary Change Notice - February Formulary Change Notice - March Formulary Change Notice - April
Enrollment in this plan is generally for the entire year. You may leave this plan or make changes generally during the Annual Election Period from October 15 to December 7. Medicare may also allow you to change plans under special circumstances, such as:
Members may enroll in this plan only during specific times of the year. Contact MedBlue Rx for more information.
The Medicare program rates how well health plans perform in different categories (for example, ratings in customer service and detecting and preventing illnesses). On www.medicare.gov you can compare the ratings for Medicare for plans in your area by selecting “Compare Medicare Prescription Drug Plans” or “Compare Health Plans and Medigap Policies in Your Area.” You can also get a copy of the ratings by calling us at 1-888-645-6025 (TTY 1-888-645-6023) - 8 a.m. to 8 p.m., seven days a week.
Submit feedback to Medicare about your BlueCross Medicare Advantage plan. A stand-alone prescription drug plan with a Medicare contract. Last updated: 4/30/12 S5953_RxWeb2012 CMS Approved 10172011
