Prescription Drug Plans

BlueCross Medicare Drug Plans

We offer three stand-alone Medicare prescription drug plans, commonly referred to as Medicare Part D plans. 

Here's what our plans—BlueCross Rx Essential, BlueCross Rx Value and BlueCross Rx Plus—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

Compare Your Options

BlueCross Rx ESSENTIAL (PDP) BlueCross Rx Value (PDP) BlueCross Rx Plus (PDP)
$26.10 monthly premium $115.90 monthly premium $207.20 monthly premium
Affordable copayments Affordable copayments No deductible/Affordable copayments
Lower-cost copayments at preferred network pharmacies Lower-cost copayments at preferred network pharmacies Low-cost generic drugs in the coverage gap
Cost-saving mail-order option Cost-saving mail-order option Cost-saving mail-order option
 

Have questions?

Discuss your Medicare Part D plan options with an agent today at 1-800-930-2836 (TTY 711).

Reach a licensed agent

Choose an SC agent or request a call whenever it's convenient for you. 

 

Frequently Asked Questions

Who's eligible for our plans?

Anyone who is entitled to Medicare Part A and/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 Plus 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 (this link leads you to a secure third-party website). 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 Plus 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.

To get a complete list of our benefits, please review the Plus Annual Notice of Changes or Value Annual Notice of Changes & the Plus Evidence of Coverage or Value Evidence of Coverage.  

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. 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.

Which prescriptions are covered?

BlueCross Rx Plus uses a prescription drug list (formulary). The formulary may change at any time. You will receive notice when necessary.

For the most current information, see our Comprehensive Plus Formulary or Value Formulary (list of covered prescription drugs effective 07/01/2021) or our Drug Search Tool (this link leads to a third-party website).

Restrictions may apply. For a list of upcoming changes, see the Formulary Change Notice.

Are there additional requirements for certain drug coverage?

Some covered drugs may have additional requirements or limits on coverage. These requirements and limits may include Prior Authorization, Quantity Limits, or Step Therapy. Links to our plan's Prior Authorization and Step Therapy criteria are below.

  • Prior Authorization: Requires you or your physician to get prior authorization for certain drugs. This means you will need to get approval before you fill your prescriptions. If you don’t get approval, the plan may not cover the drug.
  • Quantity Limits: For certain drugs, the plan limits the amount of the drug that will be covered.
  • Step Therapy: In some cases, the plan requires you to first try certain drugs to treat your medical condition before another drug will be covered for that condition.
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.

  • Lower your risk for potential harmful drug reactions and side effects
  • Teach you why it’s important to take your medications on time
  • Help 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. 

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Forms & Policies

Submit coverage appeals, share feedback about your plan, report fraud and review other forms and policies associated with your plan. 

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Contact

Reach us with questions about your Medicare coverage. Take a look at our contact information based on your question or concern. 

Reach Us

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.