We offer three stand-alone Medicare prescription drug plans, commonly referred to as Medicare Part D plans.
Here's what our plans — BlueCross Rx EssentialSM, BlueCross Rx ValueSM and BlueCross Rx PlusSM — offer:
- Access to a pharmacy network that includes most national chains and mail-order pharmacy services
- Easy prescription refills — get your prescriptions mailed to you when you use mail-order pharmacy services
- More savings with our mail-order pharmacy
- A plus plan that has no deductible and includes gap coverage when you buy generic drugs
Important Message About What You Pay for Vaccines — Our plan covers most Part D vaccines at no cost to you, even if you haven’t paid your deductible. Call Customer Service for more information.
Important Message About What You Pay for Insulin — You won’t pay more than $35 for a one-month supply of each insulin product covered by our plan, no matter what cost-sharing tier it’s on, even if you haven’t paid your deductible.
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Frequently Asked Questions
- Who's eligible for our plans?
Anyone who is entitled to Medicare Part A or enrolled in Medicare Part B and who lives in South Carolina is eligible to join our plans, regardless of income and resources, pre-existing conditions or current prescription drug expenses. Our service area is the state of South Carolina. You must continue to pay your Medicare Part B premium.
- Where can I get my prescriptions?
BlueCross BlueShield of South Carolina has formed a network of pharmacies that you must use to receive BlueCross Rx PlusSM plan benefits. In general, you must use network pharmacies to access your prescription drug benefit, except in special circumstances. The pharmacy network may change at any time. You will receive notice when necessary.
For an up-to-date list of the pharmacies in our network, see our Pharmacy Directory, or search by location using the Pharmacy Locator.* You may also request that a printed pharmacy directory be mailed to you by calling Customer Service at 1-888-645-6025.
- How can I compare my options?
You can compare BlueCross Rx PlusSM to other plans using our Summary of Benefits. Please note the Summary of Benefits doesn't list every service that we cover or list every limitation or exclusion.
- Am I eligible for subsidized coverage?
You may be able to get Extra Help to pay for your prescription drug premiums and costs. To see if you qualify for getting Extra Help, call:
- 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day, seven days a week.
- The Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call 1-800-325-0778.
- Your state medicaid office.
Learn about the Medicare Extra Help program here. This program provides additional help for people with limited income. You can also view the Centers for Medicare and Medicaid Services (CMS)* Best Available Evidence (BAE) policy.
*CMS is an independent organization that provides health information you may find helpful.
- Which prescriptions are covered?
BlueCross RxSM uses a prescription drug list (formulary). The formulary may change at any time. You will receive notice when necessary.
Restrictions may apply. For a list of upcoming changes, see the Formulary Change Notice.
- Are there additional requirements for certain drug coverage?
- What is the Medication Therapy Management program?
Medication Therapy Management (MTM) Program
The MTM Program is a free service for eligible members of our plan and is not considered a benefit. This program is designed to help members keep their medications on the right track.
The purpose is to make sure all your medications are the right choice for your medical conditions Teach you how to get the most from your medications.
It’s easy to get started in the MTM program. If you are eligible, you are automatically enrolled, and you will receive a letter in the mail inviting you to participate. There is no added cost for participating, and you may decline individual services or opt-out of the program at any time. Learn more about the MTM Program and its benefits, which can include:
- Lowering your risk for potential harmful drug reactions and side effects.
- Teaching you why it’s important to take your medications on time.
- Helping you potentially find ways to save money.
Shop for Plans in Your Area
Use our online enrollment and comparison tools to shop for plans. Note: this link will direct you to another site and prompt you to share your zip code for plan information.
Last Updated: October 4, 2023
BlueCross BlueShield of South Carolina is a Medicare Advantage PPO and HMO plan with a Medicare contract. BlueCross Essential, Rx Value and BlueCross Rx Plus are stand-alone prescription drug plans with a Medicare contract. Enrollment in BlueCross Total, BlueCross Total Value, BlueCross Blue Basic, BlueCross Secure, BlueCross Essential, BlueCross Rx Value or BlueCross Rx Plus depends on contract renewal.
This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments and restrictions may apply. Benefits, premiums and/or copayments/coinsurance may change on January 1 of each year.
Out-of-network/non-contracted providers are under no obligation to treat BlueCross BlueShield of South Carolina Medicare members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call Customer Service or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.
BlueCross BlueShield of South Carolina does not discriminate on the basis of race, color, national origin, disability, age, sex, gender identity, sexual orientation or health status in our health plans, when we enroll members or provide benefits. Free language interpretation services are available for those who cannot read or speak English. Read our Non-Discrimination Statement and Foreign Language Access policy.